Distress

by Greg Egan

  The city’s trams went almost everywhere, but so did the covered cycleways, so I’d ridden the Whirlwind to my afternoon appointment.

  James Rourke was Media Liaison Officer for the Voluntary Autists association. A thin, angular man in his early thirties, in the flesh he’d struck me as painfully awkward, with poor eye contact and muted body language. Verbally articulate, but far from telegenic.

  Watching him on the console screen, though, I realized how wrong I’d been. Ned Landers had put on a dazzling performance, so slick and seamless that it left no room for any question of what was going on beneath. Rourke put on no performance at all – and the effect was both riveting and deeply unsettling. Coming straight after Delphic Biosystems’ elegant, assured spokespeople (teeth and skin by Masarini of Florence, sincerity by Operant Conditioning plc), it would be like being jolted out of a daydream by a kick in the head.

  I’d have to tone him down, somehow.

  I had a fully autistic cousin, myself. Nathan. I’d met him only once, when we were both children. He was one of the lucky few who’d suffered no other congenital brain damage, and at the time he was still living with his parents in Adelaide. He’d shown me his computer, cataloguing its features exhaustively, sounding scarcely different from any other enthusiastic thirteen-year-old technophile with a new toy. But when he’d started demonstrating his favorite programs – stultifying solo card games, and bizarre memory quizzes and geometric puzzles that had looked more like arduous intelligence tests than anything I could think of as recreation – my sarcastic comments had gone right over his head. I’d stood there insulting him, ever more viciously, and he’d just gazed at the screen, and smiled. Not tolerant. Oblivious.

  I’d spent three hours interviewing Rourke in his small flat; VA had no “central office”, in Manchester or anywhere else. There were members in forty-seven countries – almost a thousand people, worldwide – but only Rourke had been willing to speak to me, and only because it was his job.

  He was not fully autistic, of course. But he’d shown me his brain scans.

  I replayed the raw footage.

  “Do you see this small lesion in the left frontal lobe?” There was a tiny dark space, a minuscule gap in the gray matter, above the pointer’s arrow. “Now compare it with the same region in a twenty-nine-year-old fully autistic male.” Another dark space, three or four times larger. “And here’s a non-autistic subject of the same age and sex.” No lesion at all. “The pathology isn’t always so obvious – the structure can be malformed, rather than visibly absent – but these examples make it clear that there’s a precise physical basis to our claims.”

  The view tilted up from the notepad to his face. Witness manufactured a smooth transition from one rock-steady “camera angle” to another – just as it smoothed away saccades: the rapid darting movements of the eyeballs, restlessly scanning and re-scanning the scene even when the gaze was subjectively fixed.

  I said, “No one would deny that you’ve suffered damage in the same part of the brain. But why not be thankful that it’s minor damage, and leave it at that? Why not count yourself lucky that you can still function in society, and get on with your life?”

  “That’s a complicated question. For a start, it depends what you mean by ‘function.’”

  “You can live outside of institutions. You can hold down skilled jobs.” Rourke’s main occupation was research assistant to an academic linguist – not exactly sheltered employment.

  He said, “Of course. If we couldn’t, we’d be classified as fully autistic. That’s the criterion which defines ‘partial autism’: we can survive in ordinary society. Our deficiencies aren’t overwhelming – and we can usually fake a lot of what’s missing. Sometimes we can even convince ourselves that nothing’s wrong. For a while.”

  “For a while? You have jobs, money, independence. What else does it take to function? ”

  “Interpersonal relationships.”

  “You mean sexual relationships?”

  “Not necessarily. But they are the most difficult. And the most … illuminating.”

  He touched a key on his notepad; a complex neural map appeared. “Everyone – or almost everyone – instinctively attempts to understand other human beings. To guess what they’re thinking. To anticipate their actions. To … ‘know them.’ People build symbolic models of other people in their brains, both to act as coherent representations, tying together all the information which can actually be observed – speech, gestures, past actions – and to help make informed guesses about the aspects which can’t be known directly – motives, intentions, emotions.” As he spoke, the neural map dissolved, and re-formed as a functional diagram of a “third person” model: an elaborate network of blocks labeled with objective and subjective traits.

  “In most people, all of this happens with little or no conscious effort: there’s an innate ability to model other people. It’s refined by use in childhood – and total isolation would cripple its development … in the same way as total darkness would cripple the visual centers. Short of that kind of extreme abuse, though, upbringing isn’t a factor. Autism can only be caused by congenital brain damage, or later physical injuries to the brain. There are genetic risk factors which involve susceptibility to viral infections in utero – but autism itself is not a simple hereditary disease.”

  I’d already filmed a white-coated expert saying much the same things – but VA members’ detailed knowledge of their own condition was a crucial part of the story … and Rourke’s explanation was clearer than the neurologist’s.

  “The brain structure involved occupies a small region in the left frontal lobe. The specific details describing individual people are scattered throughout the brain – like all memories – but this structure is the one place where those details are automatically integrated and interpreted. If it’s damaged, other people’s actions can still be perceived and remembered – but they lose their special significance. They don’t generate the same kind of ‘obvious’ implications; they don’t make the same kind of immediate sense.” The neural map reappeared – this time with a lesion. Again, it was transformed into a functional diagram – now visibly disrupted, overlaid with dozens of dashed red lines to illustrate lost connections.

  Rourke continued, “The structure in question probably began to evolve toward its modern human form in the primates, though it had precursors in earlier mammals. It was first identified and studied – in chimpanzees – by a neuroscientist called Lamont, in 2014. The corresponding human version was mapped a few years later.

  “Maybe the first crucial role for Lamont’s area was to help make deception possible – to learn how to hide your own true motives, by understanding how others perceive you. If you know how to appear to be servile or cooperative – whatever’s really on your mind – you have a better chance of stealing food, or a quick fuck with someone else’s partner. But then … natural selection would have upped the ante, and favored those who could see through the ruse. Once lying had been invented, there was no turning back. Development would have snowballed.”

  I said, “So the fully autistic can’t lie – or judge someone else to be lying. But the partially autistic…?”

  “Some can, some can’t. It depends on the specific damage. We’re not all identical.”

  “Okay. But what about relationships?”

  Rourke averted his gaze, as if the subject was unbearably painful – but he continued without hesitation, sounding like a fluent public speaker delivering a familiar lecture. “Modeling other people successfully can aid cooperation, as well as deception. Empathy can act to improve social cohesion at every level. But as early humans evolved a greater degree of monogamy – at least, compared to their immediate ancestors – the whole cluster of mental processes involved in pair-bonding would have become entangled. Empathy for your breeding partner attained a special status: their life could be, in some circumstances, as crucial to the passing on of your genes as your own.

  “Of cou
rse, most animals will instinctively protect their young, or their mates, at a cost to themselves; altruism is an ancient behavioral strategy. But how could instinctive altruism be made compatible with human self-awareness? Once there was a burgeoning ego, a growing sense of self in the foreground of every action, how was it prevented from overshadowing everything else?

  “The answer is, evolution invented intimacy . Intimacy makes it possible to attach some, or all, of the compelling qualities associated with the ego – the model of the self – to models of other people. And not just possible – pleasurable. A pleasure reinforced by sex, but not restricted to the act, like orgasm. And not even restricted to sexual partners, in humans. Intimacy is just the belief – rewarded by the brain – that you know the people you love in almost the same fashion as you know yourself.”

  The word “love” had come as a shock, in the middle of all that sociobiology. But he’d used it without a hint of irony or self-consciousness – as if he’d seamlessly merged the vocabularies of emotion and evolution into a single language.

  I said, “And even partial autism makes that impossible? Because you can’t model anyone well enough to really know them at all?”

  Rourke didn’t believe in yes-or-no answers. “Again, we’re not all identical. Sometimes the modeling is accurate enough – as accurate as anyone’s – but it’s not rewarded: the parts of Lamont’s area which make most people feel good about intimacy, and actively seek it out, are missing. Those people are considered to be ‘cold’, ‘aloof.’ And sometimes the reverse is true: people are driven to seek intimacy, but their modeling is so poor that they can never hope to find it. They might lack the social skills to form lasting sexual relationships – or even if they’re intelligent and resourceful enough to circumvent the social problems, the brain itself might judge the model to be faulty, and refuse to reward it. So the drive is never satisfied – because it’s physically impossible for it to be satisfied.”

  I said, “Sexual relationships are difficult for everyone. It has been suggested that you’ve merely invented a neurological syndrome which allows you to abdicate responsibility for problems which everyone faces, as a matter of course.”

  Rourke stared down at the floor and smiled indulgently. “And we should just pull ourselves together, and try harder?”

  “Either that, or have autografts to correct the damage.” A small number of neurons and glial cells could be removed from the brain without harm, regressed to an embryonic state, multiplied in tissue culture, then reinjected into the damaged region. Artificially maintained gradients of embryonic marker hormones could fool the cells into thinking that they were back in the developing brain, and guide them through a fresh attempt to build the necessary synaptic connections. The success rate was unimpressive for the fully autistic – but for people with relatively small lesions, it was close to forty per cent.

  “The Voluntary Autists don’t oppose that option. All we’re campaigning for is the legalization of the alternative.”

  “Enlargement of the lesion?”

  “Yes. Up to and including the complete excision of Lamont’s area.”

  “ Why? ”

  “Again, that’s a complicated question. Everyone has a different reason. For a start, I’d say that as a matter of principle, we should have the widest possible range of choices. Like transsexuals.”

  That was a reference to another kind of brain surgery which had once been highly controversial: NGR. Neural gender reassignment. People born with a mismatch between neural and physical gender had been able to have their bodies resculpted – with increasing precision – for almost a century. In the twenties, though, another option had become feasible: changing the gender of the brain; altering the hardwired neural map of the body image to bring it into line with the existing flesh and blood. Many people – including many transsexuals – had campaigned passionately against legalizing NGR, fearing coercion, or surgery carried out on infants. By the forties, though, it had become generally accepted as a legitimate option, freely chosen by about twenty per cent of transsexuals.

  I’d interviewed people undergoing every kind of reassignment operation, for Gender Scrutiny Overload . One neural man born with a female body had proclaimed ecstatically – after being resculpted en-male – “This is it! I’m free, I’m home!” And another – who’d opted for NGR – had gazed into a mirror at her unchanged face and said, “It’s like I’ve broken out of some kind of dream, some kind of hallucination, and I can finally see myself as I really am.” Judging from audience feedback to Gender , the analogy would attract enormous sympathy – if it was allowed to stand.

  I said, “The endpoint of either operation on transsexuals is a healthy man or woman. That’s hardly the same as becoming autistic.”

  Rourke countered, “But we do suffer a mismatch, just like transsexuals. Not between body and brain – but between the drive for intimacy, and the inability to attain it. No one – save a few religious fundamentalists – would be cruel enough to tell a transsexual that they’ll just have to learn to live with what they are, and that medical intervention would be a wicked self-indulgence.”

  “But no one’s stopping you from choosing medical intervention. The graft is legal. And success rates are sure to improve.”

  “And as I’ve said, VA don’t oppose that. For some people, it’s the right choice.”

  “But how can it ever be the wrong choice? ”

  Rourke hesitated. No doubt he’d scripted and rehearsed everything he’d wanted to say – but this was the heart of it. To have any hope of winning support for his cause, he was going to have to make the audience understand why he did not want to be cured.

  He said carefully, “Many fully autistic people suffer additional brain damage, and various kinds of mental retardation. In general, we don’t. Whatever damage we’ve suffered to Lamont’s area, most of us are intelligent enough to understand our own condition. We know that non-autistic people are capable of believing that they’ve achieved intimacy. But in VA, we’ve decided we’d be better off without that talent.”

  “Why better off?”

  “Because it’s a talent for self-deception.”

  I said, “If autism is a lack of understanding of others … and healing the lesion would grant you that lost understanding—”

  Rourke broke in, “But how much is understanding – and how much is a delusion of understanding? Is intimacy a form of knowledge – or is it just a comforting false belief? Evolution isn’t interested in whether or not we grasp the truth, except in the most pragmatic sense. And there can be equally pragmatic falsehoods. If the brain needs to grant us an exaggerated sense of our capacity for knowing each other – to make pair-bonding compatible with self-awareness – it will lie, shamelessly, as much as it has to, in order to make the strategy succeed.”

  I’d fallen silent, not knowing how to respond. Now I watched Rourke waiting for me to continue. Though he appeared as awkward and shy as ever, there was something in his expression which chilled me. He honestly believed that his condition had granted him an insight no ordinary person could share – and if he didn’t exactly pity us our hardwired capacity for blissful self-deception, he couldn’t help but perceive himself as having the broader, clearer view.

  I said haltingly, “Autism is a … tragic, disabling disease. How can you … romanticize it into nothing more than some kind of … viable alternative lifestyle?”

  Rourke was polite, but dismissive. “I’m not doing any such thing. I’ve met over a hundred fully autistic people, and their families. I know how much pain is involved. If I could banish the condition tomorrow, I’d do it.

  “But we have our own histories, our own problems, our own aspirations. We’re not fully autistic – and excision of Lamont’s area, in adulthood, won’t render us the same as someone who was born that way. Most of us have learned to compensate by modeling people consciously, explicitly – it takes far more effort than the innate skill, but when we lose what little we have of
that, we won’t be left helpless. Or ‘selfish’, or ‘merciless’, or ‘incapable of compassion’ – or any of the other things the murdochs like to claim. And being granted the surgery we’ve asked for won’t mean loss of employment, let alone the need for institutional care. So there’ll be no cost to the community—”

  I said angrily, “Cost is the least of the issues. You’re talking about deliberately – surgically – ridding yourself of something … fundamental to humanity .”

  Rourke looked up from the floor and nodded calmly, as if I’d finally made a point on which we were in complete agreement.

  He said, “Exactly. And we’ve lived for decades with a fundamental truth about human relationships – which we choose not to surrender to the comforting effects of a brain graft. All we want to do now is make that choice complete. To stop being punished for our refusal to be deceived.”

  #

  Somehow, I whipped the interview into shape. I was terrified of paraphrasing James Rourke; with most people, it was easy enough to judge what was fair and what wasn’t, but here I was on treacherous ground. I wasn’t even sure that the console could convincingly mimic him – when I tried it, the body language looked utterly wrong, as if the software’s default assumptions (normally used to flesh out an almost-complete gestural profile gleaned from the subject) were being pumped out in their entirety to fill the vacuum. I ended up altering nothing – merely extracting the best lines, and setting them up with other material – and resorting to narration, when there was no other way.