By Pete Kotz
By Michael Musto
By Michael Musto
By Capt. James Van Thach told to Jonathan Wei
By Kera Bolonik
By Michael Musto
By Nick Pinto
By Steve Weinstein
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 possible war with Iraq, but the prospect of a soul absolved by meds remains very real. Feelings of guilt and regret travel neural pathways in a manner that mimics the tracings of ingrained fear, so a prophylactic against one could guard against the other. Several current lines of research, some federally funded, show strong promise for this.
At the University of California at Irvine, experiments in rats indicate that the brain's hormonal reactions to fear can be inhibited, softening the formation of memories and the emotions they evoke. At New York University, researchers are mastering the means of short-circuiting the very wiring of primal fear. At Columbia University one Nobel laureate's lab has discovered the gene behind a fear-inhibiting protein, uncovering a vision of "fight or flight" at the molecular level. In Puerto Rico, at the Ponce School of Medicine, scientists are discovering ways to help the brain unlearn fear and inhibitions by stimulating it with magnets. And at Harvard University, survivors of car accidents are already swallowing propranolol pills, in the first human trials of that common cardiac drug as a means to nip the effects of trauma in the bud.
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 Nuremberg plea?"I was just following orders"?to be made easier with pharmaceuticals? Though the research so far has been limited to animals and the most preliminary of human trials, the question is worth debating now.
"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 Uniformed Services University of the Health Sciences. "If soldiers are going to have that lower threshold, we might have to build in even stronger safeguards than we have right now against, say, blowing away human shields. We'll need a higher standard of proof [that an action is justified]."
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.
Combat and psychoactive chemicals have always been inseparable, whether the agent was alcohol or a space-age pill. A half-century after Japan hopped its soldiers up on methylamphetamines during World War II, the U.S. has pilots currently in the dock for mistakenly bombing Canadian troops while using speed to stay awake. When Eric Kandel, the Nobel laureate in medicine who works out of Columbia, was asked if his genetic exploration of fear was funded by the Pentagon's Defense Advanced Research Projects Agency, he quipped, "No, but you're welcome to call them and tell them about me."
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