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She is gone

2016; Elsevier BV; Volume: 15; Issue: 12 Linguagem: Inglês

10.1016/s1474-4422(16)30142-9

1474-4465

Marco De Ambrogi,

Empathy and Medical Education

Where emotions and memories might reside in the brain is a fascinating topic, and the idea that an intervention could delete specific memories is not new—for example, this concept was originally explored in the movie Eternal Sunshine of a Spotless Mind, where a firm called Lacuna was able to intervene and erase specific memories; in particular, those relative to failed relationships. But when deletion of specific memories is an accidental side-effect of an intervention to cure a neurological disease, serious ethical questions are raised. Playwright Nick Payne had already started to investigate this possibility in his previous play Incognito, in which he presented the real story of Henry Molaison, known in scientific circles as Patient HM. In 1953 he had a bilateral medial temporal lobe resection, including the hippocampus, most of the amygdala, and the entorhinal cortex, to cure his epileptic seizures. Molaison then had chronic memory loss as a result, and over the next few decades was examined by neuroscientists attempting to uncover the secrets of the brain. Payne returns to question the price of intervention in neurological diseases, if there is the risk of causing extensive loss of memories, in his new play Elegy, which has recently opened under Josie Rourke's direction at the Donmar Warehouse in London (UK). In the first scene, two women, Lorna and Cassie, meet; Lorna (Zoe Wanamaker) has just been released from a hospital. She does not remember having known Cassie (Barbara Flynn) before, but her lawyer has arranged the appointment because this woman has requested a meeting. Lorna has had an innovative surgical intervention that has removed all of her neurons that were damaged by a devastating disease, which could have been a dementia, although this assumption is never clarified, and replaced them with a synthetic neuronal prosthesis. Although the operation has given Lorna back her health and the possibility to restart her life anew in her 60s, it has also completely destroyed her memories of the previous 25 years. What Lorna harrowingly does not recall is that Cassie has been her partner for all of those years, after they met in church while they were both in their 40s. Cassie is understandably puzzled and devastated that Lorna does not remember anything of their past together. When Lorna finally admits that she is repulsed by the idea of kissing Cassie and it would be preferable to get their marriage annulled for the sake of her new life, it is heartbreaking. The play then moves backwards in time, slowly revealing Lorna and Cassie's life together when they were preparing their wedding, the first signs of Lorna's disease, their fear about how it could progress and affect their relationship, and their meeting with Miriam (Nina Sosanya), a rather cold and unsympathetic doctor who proposes the substitution of the damaged neurons with a chip, as the technique “has never failed”. Miriam reveals only at the end of the play the tragic personal reason that makes her so strongly in favour of the operation. When the operation is discussed with Miriam, Lorna is absolutely against the idea of having her damaged neurons replaced because of the risk of losing all memories of her life with Cassie. Nevertheless, Cassie is given the power of attorney and, when she is finally faced with the dramatic decline of her partner's health and mental capacity, she decides to give her the chance to gain a new lease of life through the intervention, hoping at the same time that some of the love that they share will be preserved. Although the play moves backwards towards what happened to the story and relationship of the two women before the operation, the audience remains on Cassie's side all night hoping that Lorna might have somehow retained part of her memory of their life together even after getting the damaged neurons removed. An answer to this harrowing question is only given in the final scene, which brings the audience back to the meeting of the two women after Lorna's release from hospital. Thus, Elegy manages to build a dramatic evening out of the idea that surgery could actually delete specific memories and affect a person's identity. This harrowing play puts at the centre of the stage an ethical question that could even be realistic in the near future: if someone we love has a neurological disease, should we let the disease progress, or allow an intervention that can restore the person's health and capacity to start a brand new life, but might cancel his or her previous memories? Cassie made the altruistic choice of giving Lorna a chance for the future, but considering the price, it might not be a choice that everyone would be ready to make. Elegy Josie Rourke Donmar Warehouse, London, UK April 21–June 18, 2016 Elegy Josie Rourke Donmar Warehouse, London, UK April 21–June 18, 2016