A soldier faces a drab cluster of buildings off a broken
highway, where the enemy is encamped among civilians. Local farmers and their
families are routinely forced to fill the basements and shacks, acting as human
shields for weapons that threaten the lives of other civilians, the soldier's
comrades, and his cause in this messy 21st-century war. There will be no surgical
strikes tonight. The artillery this soldier can unleash with a single command
to his mobile computer will bring flames and screaming, deafening blasts and
unforgettably acrid air. The ground around him will be littered with the broken
bodies of women and children, and he'll have to walk right through. Every value
he learned as a boy tells him to back down, to return to base and find another
way of routing the enemy. Or, he reasons, he could complete the task and rush
back to start popping pills that can, over the course of two weeks, immunize
him against a lifetime of crushing remorse. He draws one last clean breath and
fires.
Pills like those won't be available to the troops heading off for war with
At the
The web of your worst nightmares, your hauntings
and panics and shame, radiates from a dense knot of neurons called the amygdala. With each new frightening or humiliating
experience, or even the reliving of an old one, this fear center triggers a
release of hormones that sear horrifying impressions into your brain. That
which is unbearable becomes unforgettable too. Unless, it seems, you act
quickly enough to block traumatic memories from taking a stranglehold.
Some observers say that in the name of human decency there are some things
people should have to live with. They object to the idea of medicating away
one's conscience.
"It's the morning-after pill for just about anything that produces
regret, remorse, pain, or guilt," says Dr. Leon Kass,
chairman of the President's Council on Bioethics, who emphasizes that he's
speaking as an individual and not on behalf of the council. Barry Romo, a national coordinator for Vietnam Veterans Against the War, is even more blunt. "That's the devil
pill," he says. "That's the monster pill, the anti-morality pill.
That's the pill that can make men and women do anything and think they can get
away with it. Even if it doesn't work, what's scary is that a young soldier
could believe it will."
Are we ready for the infamous
"If you have the pill, it certainly increases the temptation for the
soldier to lower the standard for taking lethal action, if he thinks he'll be
numbed to the personal risk of consequences. We don't want soldiers saying
willy-nilly, 'Screw it. I can take my pill and even if doing this is not really
warranted, I'll be OK,' " says psychiatrist
Edmund G. Howe, director of the Program on Medical Ethics at the
The scientists behind this advance into the shadows of memory and fear don't
dream of creating morally anesthetized grunts. They're trying to fend off
post-traumatic stress disorder, or PTSD, so that women who've been raped can
leave their houses without feeling like targets. So that survivors of terrorist
attacks can function, raise families, and move forward. And yes, so that those
young soldiers aren't left shattered for decades by what they've seen and done
in service.
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Combat and psychoactive chemicals have always been inseparable, whether the
agent was alcohol or a space-age pill. A half-century after
Imagine a world where the same pill soothed victims and perpetrators alike.
Henry David Thoreau advised, "Make the most of your regrets; never smother
your sorrow. . . . To regret deeply is to live afresh." Without remorse,
there would have been no John Newton, a slave trader who found religion during
a harrowing storm at sea and later became an abolitionist; he's best known for
penning "Amazing Grace."
For doctors, the drugs would present a tricky dilemma. Most people exposed
to traumatic situations don't end up with PTSD, but there are few means of
knowing on the spot who might need treatment much
further down the line. Researchers say that for the medicines to be effective,
patients would need to take them soon after the upsetting event. The temptation
for physicians might be to err on the side of caution, at the cost of curbing
normal emotional responses. Victims might be eager to avoid lasting pain,
wrongdoers the full sting of self-examination.
"The impulse is to help people to not fall apart. You don't want to
condemn that," says Kass. "But that you
would treat these things with equanimity, the horrible things of the world, so
that they don't disturb you . . . you'd cease to be a human being."
The very idea of PTSD has been attacked as a social construction, a vague
catchall that provides exculpation for the misdeeds of war. But researchers are
trying to prevent the onset of a disease, not change the social circumstances
that bring it about. James L. McGaugh, a
neurobiologist at U.C. Irvine whose study of stress hormones and memory
consolidation in rats is one of the cornerstones of the effort, acknowledges
the ambiguities but comes out swinging in defense of his work. "Is it
immoral to weaken the memory of horrendous acts a person has committed? Well, I
suppose one might make that case. Some of your strongest memories are of
embarrassments and of the guilty things you did. It doesn't surprise me at all
that people would wake up screaming, thinking of the young children they killed
in
Nevertheless, fellow fear researcher Dr. Gregory Quirk of the Ponce School
of Medicine, in
There are reasons to believe our military would covet mastery of Quirk's
technique in humans. People at war dehumanize their enemies to make killing
more palatable. Now, in the war on terror, our modern cultural taboos against
torture are fraying. Put yourself in the room then. The commission of heinous
acts, even deliberate torture, can also visit lifelong torment on perpetrators
who aren't hardwired very well to be sadistic. The sounds of screaming - a
primordial alert that mortal danger is near - trigger those damning hormones
even in the torturer.
And couple Quirk's magnetic manipulation of the brain with this: "One
of the horrible things I discovered after the Gulf War was that, because of the
coeducation of wars, as it were, male soldiers were given extensive
desensitization training to make them able to hear women being raped and
tortured in the next room without breaking," Kass
says. "It's a deformation of the soul of the first order. I cannot speak
about it without outrage."
But a trauma-born irrational aversion to necessary war - pacifism in the
face of an expanding evil - isn't healthy either. "Such emotions can blind
us as well as make us wiser," says Howe. "It's possible that these
kinds of drugs would help patients see in a clearer way." On the flip
side, could anyone possibly maintain that Ahab was a better captain for not
having been chemically mollified after the white whale bit off his leg?
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An uncomfortable reality is that war isn't an aberration; it has a very codified place in our culture. We agree through
treaties to normalize it. We demand punishment for soldiers who violate those
treaties, though more often those from the losing side. But we don't deny them medical
treatment. And one needn't have committed a war crime to feel wracked by
sorrow. "In my dreams I meet six Vietnamese people I murdered. Whether
they had a gun on them is irrelevant," says Romo,
who, as a 19-year-old lieutenant, served as a platoon leader in the 196th Light
Infantry Brigade in 1967 and 1968. His ticket home was as a body escort for his
similarly aged nephew, who served in the same unit. "I returned to the
Romo and veterans like him have taken it upon
themselves to use their experiences to teach peace. But veterans torn apart by
PTSD don't have a choice about being Exhibit A in the case against war.
"When you see what can happen to a young person, it passes on in a very
real way, not in a history-class sense, that reality of what war and blood
really is," he says. Who are we to impose this emotional albatross on
soldiers? As a nation, we elect our leaders. It seems unjust to make veterans a
special class to suffer for our sins in wrongheaded wars, or pay a continuing
price for victory in the "good" ones.
"That's a heavy burden to put on people to preserve the morality you're
talking about," says Dr. Roger K. Pitman of
There's another context to be considered as well, McGaugh
notes, one that was made clear by the recent demand from representatives
Charles B. Rangel of
But PTSD doesn't result solely from war. When Kass
first heard of McGaugh's research, at a presentation
in October, he had a far more intimate horror in mind: rape. "At
fraternity parties they'll be popping Ecstasy at night and forgetfulness in the
morning," he growls.
The victim would be an obvious candidate for an anti-trauma drug. Would
dulling her emotional memories of the event help her to endure the lengthy,
perhaps humiliating, pursuit of justice through the courts, or would it rob her
of the righteous anger she'll need to persevere and perhaps the empathy to
later help other victims? The rapist is part of the equation too. If his victim
stabbed him in her own defense, no doubt he would be bodily healed. No
physician could refuse to treat him. "If such a person had PTSD stemming
from the circumstances of the act, he could be a candidate [for therapy],"
Pitman says.
How much of our remorse do we have a right to dispense with, and how much
exists in service to others, a check on our worst impulses? "Each
experience we have changes our brain and in some sense alters who we are,"
says Dr. Joseph E. LeDoux of NYU, who studies
emotional memory. "The more significant the experience,
the more the alteration. We have to decide as a society how far we want to
go in changing the self. Science will surely give us new and powerful ways of
doing this. Individuals may want more change than society wants to
permit."