Love in the Lab

Let’s talk about love. Nothing new. It’s all around, in the air. In a scientific institute, which is as near a bio-bubble in everyday life as can be, we all see the tentative overtures of love, the distracted state of early love, love in full bloom and then sometimes the broken hearts mourning their loss, all through the lens of the frustrated guide or joyful friends or annoyed lab mates, depending on where we may be placed at that particular phase of life. So, one wonders why love stories are not written about love amidst the test tubes. I was pleasantly surprised to recently discover two separate books on this topic. Both set in biology labs, both poles apart from each other in their treatment of the topic. The Love Hypothesis by Ali Hazelwood. Hazelwood is a cognitive neuroscientist (with all my googling I was unable to figure out where her lab is!) who, near the end of her PhD, got frustrated and decided to write romance novels in a science setting. Love Hypothesis, her first book, is in fact just a regular romcom, with the regular elements of the strong silent type hero and a bubbly crazy heroine. Her modus operandi is, as she says in her numerous interviews given when her book hit the New York Times bestseller list (!!), to use the usually used tropes of romcoms, but transplant it into a lab/science setting. And that is exactly what she has done. It is hilarious, but rather incongruous. I have seen professors who are obsessed with work and are anti-social, but I am yet to see one who also sports 6-pack abs and is drop-dead gorgeous. But keep looking, perhaps they exist. I can certainly relate to the feelings of insecurity, inadequacy, lack of funds and big ambitions sported by our heroine, a PhD student. But she does get into some really contrived unreal situations. Of course, love blooms and they live happily ever after. So, as a book of the romcom genre, set in the lab, this book fits the bill. Experimental Heart by Jennifer L Rohn. Rohn is a microbiologist with an interest in urinary tract infections who works in University College London. Experimental Heart is her first novel. It is difficult to define the book as a romance, although that is the primary undercurrent that runs through the book from beginning to the end. Love (or not?) between two postdocs across the labs windows where both are busy burning the midnight oil. Andy and Gina, both brilliant in their own fields, populate the two sides of science, academia and industry. We follow the two of them as they negotiate the prejudices and stereotypes of the light and the dark side. As they desperately try to make a difference, do something relevant, make their lives and their science meaningful all the while stealing glances across the room, borrowing enzymes, addressing reviewer’s comments, getting attracted to ‘other’ people. Gina would take all help available to make her vaccine against a deadly disease that affects children, a reality. But Andy uncovers uncomfortable evidence that there may be foul play afoot, but lacks the confidence to break it to Gina. In the end, true to a good mystery, things heat up, it all comes apart and Andy gets a chance to play the knight in shining armour. But Experimental Heart is a complex love story. There are no black and whites, no rights and wrongs, no surety in love. It feels uncomfortably like real life. Rohn uses the storyline also to throw out debates on academia and industry, the ethics of animal research, the rights and wrongs of genetically modified crops, debates that we as scientists face frequently; where we are left with the lingering unease that we are not very sure of our righteousness although we cover it up with a general trust-me-I-am-a-scientist bluster. So, in summary, if tonight you are in the mood for a little fantasy to take your mind off those failed experiments and are at your wit’s end, pick up The Love Hypothesis. However, if it is a day when you are of a more ruminative mind, but still need to take your mind off your own problems, take Experimental Heart to bed. This review appeared in IGIB Pulse, 31 August 2022

Autism: Accepting our differences

April is Autism Awareness Month

Priyam was the life of the party at the day care centre. A bright-eyed boy who captured the heart of the caretakers and played with abandon. Sometime after his second birthday, all this started changing. He stopped playing with his toys, he seemed more interested in organizing them now. He stopped talking, not even responding even when called by name. He stopped smiling at people and making eye contact. Then the rhythmic movements started; rocking his body, banging his head or repeatedly tapping on the table. One day he banged his head so much that when his father came hurriedly summoned by the caretaker, there was a trickle of blood running down his face. That was his last day at the centre; they refused to keep him after that. 

Nancy was different. Growing up in a family with siblings and grandparents, she was used to people. But outsiders were studiously ignored. She heard all the questions and comments, but never acknowledged them. Loud noises, rough-textured clothes, squishy toys, strong smelling foods, all caused strong aversion. Now ten, she ventures out to play with other kids. She is often confused by the endless chatting of the other kids. She cannot fathom why they can’t just come, play and go home. She comes home crying most days because the others refused to include her in their play. She is smart, she understands that she is doing something wrong, but does not know what. 

After multiple visits to the paediatrician and clinical psychologists, numerous questionnaires, behavioural evaluations through observations and play, both Nancy and Priyam were diagnosed to have Autism Spectrum Disorder (ASD). People with ASD have difficulties in social interaction and communication, show repetitive behaviours like rocking movements or repeating certain words over and over again and are obsessive about routine and order in their daily lives. Between 1 in 50 to 1 in 150 people have a diagnosis of ASD in countries where this is being systematically done. In India, we do not have sufficiently uniform access to diagnosis to know the numbers.

A range of conditions previously known as Autism or Pervasive Developmental Disorder (PDD) or Asperger’s Syndrome now come under the common umbrella of Autism Spectrum Disorders (ASD). Like Priyam and Nancy, people with ASD have very diverse difficulties, hence the term ‘spectrum’ is used. True to the name, brain scans of people with ASD show a range of differences: in the volume and size of brain and in the numbers and connectivity of neurons in the brain. But none of these differences are enough to diagnose a child as being on the Autism Spectrum. We know that the brains of ASD people are different from the brains of neurotypical people, but we still do not know how that causes the behavioural changes. Autism is mostly genetic; the risk for autism increases in families with previous cases of ASD. But there is no single ‘autism gene’ that can be tested for risk. The condition is a result of brain development being affected by a combination of nearly 100 or so genes.

High-functioning ASD kids, like Nancy, find it difficult to navigate the social world, but they are independent, able to attend mainstream schools, find employment and thrive. Many times, they excel at something that gets them noticed among their peers such as extraordinary mathematical, musical or artistic abilities. For such ‘high-functioning’ autistic kids, these skill make their journey through life somewhat easier. But at the other end of the ASD spectrum are the children who do not speak beyond a few words, like Priyam. Some, but not all nonverbal children, may also have intellectual disability. These children would usually need occupational therapy to identify objects by name, to learn to ask for help and communicate with others. 

In a recent study scientists tested the communication abilities of neurotypical adults with autistic adults and autistic adults with other autistic adults. Very surprisingly, they found that autistic people could communicate with each as well as neurotypical people can with other neurotypical adults. This study revealed that perhaps it is not just the ASD individuals who need help with communication. But rather, the rest of the society should also learn how to communicate with, work with and value the diversity of brains we have amongst us. As parents, as teachers, as friends and family, we must learn how to open our arms and minds to differences amongst us. Many autistic children go on to live happy, fulfilled, loved and loving adult lives. But this journey always begins with acceptance and engagement at home and the immediate social circle. 

A modified version of this article was published in The Indian Express on 29 April 2022

Hallucinations: Did I just imagine it?

I still remember walking down the as-usual deserted Inman Street in Cambridge, Massachusetts and suddenly pulling up short and looking around as the smell of my mother’s sambhar surrounds me! At that moment I would have given anything to get a taste of that sambhar! But I knew there were no Indian households in the area. I knew none of the sealed double-glazed windows in the vicinity could be the source of the smell. I was, in fact, having an olfactory hallucination. Oliver Sacks, one of the most prolific neurologist-writers who through his writings let us look inside human brains through the eyes of his patients, said, while talking about his book Hallucinations, ‘We see with our eyes, but we see with our brains as well. Seeing with the brain is called imagination’. When I sit and stare into space daydreaming, I call that imagination. Michelangelo hanging upside down under the ceiling of the Sistine Chapel and visualising the hand of god reaching out to man; I call that imagination. Artists planning and cutting away around 200,000 tonnes of rock out of the side of a mountain to create the exquisite Ellora caves; I call that imagination. But what if that ‘seeing’ is involuntary, it is not in our control? If we cannot control when we start ‘seeing’ and what we ‘see’? What if we cannot tell if we are ‘seeing’ with the brain or with our eyes? A hallucination is defined as a sensory perception that occurs in the absence of an external sensory stimulus. Hallucinations can be visual: seeing visions, ghosts or people, auditory: hearing voices, olfactory: sensing smells and tastes or tactile: feeling a touch or itching or insects crawling on the skin. Hallucinations are quite common; according to various studies 5%-70% people would experience a hallucinatory experience some time in their life. We just don’t talk about it for fear of being thought of as crazy. But seeing visions or hearing voices were not always thought of as signs of insanity; not so very long ago, they would have been considered an indication of divine powers. But a life where you do not know the real from unreal can be hell indeed. Schizophrenia is a particularly debilitating disorder where patients see visions and hear voices that sometimes curse, berate and insult them, making them psychotic and paranoid. For instance, John Nash, the brilliant mathematician whose story was captured in the book and movie Beautiful Mind, had a friend who lived with him and had a great influence on his life, only to realise many years later that this friend was imaginary. He later developed defensive strategies to check with people around him to make sure what he was seeing was what everyone else was seeing. Imagine living with such self doubt! Elyn Saks, the law professor who has worked tirelessly for mental health patients, says it all in the title of her book chronicling her ‘journey through madness’, The Center Cannot Hold. She describes the feeling of being completely out of control when there is no boundary between reality and hallucination and the mind does not know what to believe in anymore. When the mind that you have relied on your whole life to stand by you, suddenly forsakes you. Our brain has to deal with large amounts of sensory data throughout the day. If it attempted to decode everything with equal attention to detail, it would probably have a nervous breakdown. Instead, the brain uses many shortcuts. It learns the patterns of predictability and many times fits the sensory inputs to the ‘expected results’ thus reducing the workload on the brain. The binocular depth inversion illusion test (BDII) tests for this ability of the brain to confabulate. A convex mask rotates on its axis. As the mask flips to the concave side, the brain ‘corrects’ the image and shows us an illusion of a convex mask. Healthy, well-rested individuals see this illusion because the visual processing system shows them what the brain thinks they are seeing, not what they are actually seeing. Schizophrenia patients and sleep-deprived people are less able to see this illusion. Their brain does not ‘correct’ for the predictable. MRI scans of people with schizophrenia who had hallucinations and those who did not, showed that people prone to hallucinations had a shorter paracingulate sulcus or PCS in their frontal lobe. They appear to be less able to distinguish between self-generated information and information received from outside sources. Other studies on schizophrenia patients prone to auditory hallucinations have also suggested that they have a weaker corollary discharge, a feedback mechanism that allows the brain to distinguish between self-generated signals and external signals; for example, they perceive no difference between self-tickling and tickling by others. Similarly, perhaps these brains cannot tell the difference between a voice generated inside their heads vs. a voice coming from outside. Hallucinations are also common in people undergoing sensory deprivation such as people incarcerated in solitary confinement. Scientific studies depriving people of all sensory inputs have shown that individuals begin experiencing distress and hallucinating within hours. People who have lost their vision or hearing often experience visual or auditory hallucinations that are much more benign that those experienced by people with illness or distress. Although hallucinations are frightening most of the time, indicating disease or extreme fatigue, human beings have always had a fascination with visions and voices of the mind. All cultures around the world have their favourite psychoactive plants and mushrooms that are used in religious rituals. The Western Counterculture movement of the 1960s also led to experimentation with hallucinatory chemicals such as LSD and Psilocin, tryptamines that bind to the Serotonin H2A receptors. Scientifically curious people have recorded their experiences after taking these compounds under controlled conditions and under supervision. Let me quote Weir Mitchell (as described by Oliver Sacks in Hallucinations), ‘The heavens above me, a night sky spangled with eyes of flame, dissolve into the most overpowering array of colours I have ever seen or imagined; many of the colours are entirely new–areas of the spectrum which I seem to have hitherto overlooked.’ People having epileptic seizures or those who have had near-death experiences report similar feelings of transcendence. A strange joy and oneness with the whole world. Perhaps what the ancient texts call nirvana? Hallucinations are a symptom of certain mental illnesses and their destructive effect cannot be denied in such cases. But it also cannot be denied that sometimes our brain plays tricks on us to lead us to a better state of mind. When blind people see colourful scenes play out in front of their mind’s eye or when a bereaved spouse meets their lost love within the recesses of their mind, the brain is trying to recapture a lost experience. People who have had mushrooms and flower extracts take them on a journey of the universe unlike any they have ever imagined say that they would give anything to get that one moment back. Would you not secretly wish you too had a window of such opportunity? As brain mapping and augmented reality come of age, would we someday check into a ‘transcendence clinic’ for a few minutes of electric stimulation that would simulate a more wonderful world than the one we live in? You can try out the binocular depth inversion illusion test (BDII) here (hyperlink below) https://michaelbach.de/ot/fcs-hollowFace/index.html This is the third in a series on Imagination that I am writing. The previous articles can be found here and here. Photo by Merlin Lightpainting