This short story is about the pain of wounds that never heal; it discusses suicidal thoughts, depression, and the lengths people will go to in order to escape the pain of the past. Drafting this story began in December of 2022, and was inspired by a research article on human memory which alluded to therapeutic uses of memory alteration.
As a long-time student of psychology, and specifically personality disorders, I’ve always been interested in how people deal with trauma and pain. Many people that publicly seem to cope well with their past are often suffering in silence, revealing the truth to few or none. This story explores that reality.
“Mary, there are no treatments left. I’ve prescribed every drug that might work, you’ve been in therapy for years, I’ve used every conventional treatment available.”
“Doctor, please, there’s got to be something better. I’m miserable. I’ve done everything I can, I’ve done everything you’ve told me, there has to be something that actually works.”
“You’ve been suffering from severe depression since you were what, 14? I know that’s been hard, but you’ve built a good life, it may be hard, but everyday you are winning.”
“Doctor… Paul, I’m not winning, I’m drowning.”
“You’ve never given me a clear answer on this, but you know I have to ask, are you having any suicidal thoughts?”
“I don’t want to answer that.”
“Why?”
“Because you’ll write the answer down, and I don’t want that to happen.”
Smoothed from Botox, the psychiatrist’s brow begins to show a slight furrow, he locks onto his patient’s eyes as if he’s reading her mind, the calm and comforting facade melts away as the truth sinks in deeper and deeper. For ten years Mary has been a regular in the office of Doctor Paul Vandermuth, a leading practitioner in the San Francisco area, and for ten years, the doctor has done everything possible to make her life better.
A troubled childhood full of abuse, hate, foster homes, and, above all, the crushing weight of everything that’s gone wrong, relived every day. Mary works hard, lives a quiet life, and to everyone appears to be happy and on top of the world. Only in the safety of the doctor’s office does her guard come down, her pain and shame exposed, only there is she not the caricature of a person that she created to show to the world.
The silver ink pen and notepad soon find their way to the doctor’s desk.
“No more notes. Just talk to me. I can’t help, if you don’t talk.”
“Not a day goes by that I don’t think about death. About dying. About how to leave this all behind without hurting anyone. About the spots on the highway where the pillars are missing safety guards and how easy it would be to just drive into one. I don’t have a plan, I’m not getting ready to do anything, but not a day goes by without the thought.”
“I’m sorry Mary, I didn’t realize it had gotten so bad.”
“Paul, this is my normal. It has been since I was 15 or 16. It’s not that it’s become this bad, this is just my every day.”
“There’s… there’s a somewhat radical experimental therapy that has good results. I can’t recommend it, the impact is too great, but it does work.”
“What are you suggesting Paul, a lobotomy?”
“No! Of course not. Though it does involve surgery and specialty drugs.”
A large commercial building sits south of the El Alto International Airport in La Paz, Bolivia, surrounded by razor wire, armed guards, and video cameras. A small sign by the main gate indicates that it is a laboratory of some sort, but not even its neighbors know anything of what happens within its walls.
It’s ownership it shrouded in secrecy just as are its activities, shell companies, leases to other shell companies, payments shuffled through a variety of bank accounts, no meaningful public records. In reality, the owner is an American, a former neurosurgeon and psychiatrist, an expat that largely disappeared from the world after a devastating malpractice lawsuit due to a failed experimental procedure.
In secret, he’s treated patients under false names, traveled the world, all to perfect a technique that uses medication and targeted electrode placement within the brain to cause a rapid loss of AMPA receptors in the brain. Long-term memories fade quickly into nothingness, many lost forever, others hazy and disassociated. His goal, to reset the brain, wiping a person’s memory, experiences, and personality.
After a successful treatment, patients typically are able to walk and talk, but may or may not know their own name, have no idea of their age, where they are, or why they are there. A radical treatment, followed by years of therapy and education, at the cost of everything a person is.
The reset allows patients to start again, building a new life from scratch, with none of the experiences that caused them pain or anxiety; none of the heartaches, none of the mistakes, none of the abuse, none of the trauma.
After surgery, the patients are transferred to a local hospital and treated as if they are suffering from memory loss due to a car accident. Hospital staff are paid to not reveal the true nature of what’s happened to them. To maintain the effect of a true reset, they are told nothing of their past life, given a new identity, and assumed dead by those that knew them.
It’s burning a life down - a loss of everything - in exchange for a chance to truly start over.
An elaborate - and happy - backstory is created, identity documents forged, social media accounts are regularly created and maintained for years and then matched to patients, apartments rented, bank accounts opened, and of course, bribes are paid to ensure that all of this goes unnoticed.
If all goes well, each patient will believe that they were happy, successful, and lost their memories after a car accident. Their true history, lost forever.
“Mary, you have to understand, this is risky, the exact impact varies from person to person, and it would mean relearning most things. All of your experiences would be gone - well, at least most would be gone. Your education would be gone. You likely wouldn’t know how to cook, or clean, or take care of yourself.”
“I wouldn’t be myself. I would be starting over with a new life. It would be hard, but maybe I could have peace. Maybe, for once, I would be free from the torture my mind constantly creates.”
“You have to realize, even your good memories would be gone. Those cornerstone memories that define who you are, would disappear in an instant. Your personality would be different, but any chemical imbalances that contribute to your depression and anxiety would still exist. Genetic factors won’t change, if you’re genetically predisposed to an illness, that’s not going away. You would wake up in a strange place with no idea who you are. It would be trying, it would be frustrating, and it may not make you any happier than you are today.”
“Paul, you’ve been a good doctor, and a good friend, you’ve helped me in many ways, but I’m tired. I don’t have the energy to keep fighting this battle. There’s nothing left.”
Over a few hours, as the patient lies with the top of their skull removed, conscious and looking at screen above the operating table, memory steadily dissolves into nothing.
This doctor created the procedure to help the most troubled patients, those so broken that no amount of drugs or therapy could help them. He experimented on those so ill they couldn’t offer consent while working at a small psychiatric hospital. Some did well, some lost the ability to form long-term memory entirely. The procedure was too risky to be trialed on humans, though he had no patience to for delays, such as animal trials to establish safety, or ethics panels to ensure he wasn’t violating the rights of his patients. A brilliant doctor, who did deeply care about helping the world, but had little concern for the price that some individuals would pay. “It will all be worth it in the end” he would tell himself.
During the procedure, images are rapidly shown to the patient, some peaceful, some happy, some dark, and some deeply disturbing. These images prompt measurable reactions in the brain, and some, importantly, prompt memories. As the procedure continues, these measurements help to show the effectiveness of the work. As the hours go by, the number of memories being recalled steadily drops, the number of AMPA receptors activated drops as memories fade.
Within a few hours a different person is created. All their experiences, their knowledge, their hopes and dreams, all gone. Every good memory and bad, gone. Their personality is gone. A blank slate.
There are possible side effects of course, such as nightmares based on disassociated memories, and some experience difficulty forming new long-term memories. Most people are able to recover quickly from the damage introduced to the brain.
The consultation fee to speak to the doctor is $10,000, paid via an anonymous cryptocurrency. The patient first flies on a small private plane to a tourist area of Mexico for an interview with one of the doctor’s associates to determine if they are good fit for the procedure. If they pass this screening, they are loaded on an even smaller private plane and flown to Bolivia to meet the doctor. This keeps investigators from finding the doctor, and ensures that the doctor only meets those that are truly ready to start over.
Few patients are referred, fewer still pass the screening. If there is any doubt about the person, their need, or the results, they are rejected. The doctor wants to prove his procedure works, and will only take patients that are likely to respond particularly well.
The other issue is cost. The minimum cost to proceed is another $240,000 - plus a year of living expenses to get each patient started. Given all the medical bills generated through this procedure, patients are advised to have $1,000,000 available when they start. Recovery is a long road, with no friends, no family, no career, just a story about a life that never was.
“Mary, I can put you in touch with the right people to get this started, but this isn’t a decision to be taken lightly. You, the true you, the you your friends know, the you I know, won’t exist anymore. There’s no going back. You won’t know what happened. You may have memories that you can’t explain. It’s the most drastic step you can take.”
“I’ve built a facade, not a life. I’ve built masks, not a person. There’s nothing true to be lost, and maybe, for the first time, there can be a true me. It’s been a long time since I’ve had hope for the future, but this gives me some.”
Five years later.
“Honey, I just had the ultrasound, it’s a girl! I know we’ve talked about a lot of different names, but since the accident, the name Mary has been in my dreams so often. I think that’s what we should name her.”
