Into the Gray Zone CHAPTER ONE THE GHOST THAT HAUNTS ME People don''t live or die, people just float She went with the man in the long black coat --Bob Dylan The scientific process works in mysterious ways. As a young neuropsychologist at the University of Cambridge, studying the relationship between behavior and the brain, I fell in love with Maureen, a Scottish woman who was also a neuropsychologist. We met in the fall of 1988 in Newcastle upon Tyne, an English city sixty miles from the Scottish border. I had been sent up to Newcastle University to solidify a collaborative relationship between my boss, Trevor Robbins, and Maureen''s boss, the improbably named Patrick Rabbitt, who was doing innovative work on how the brain ages. Maureen and I were thrust together. I was immediately charmed by her dry wit, amazing head of chestnut hair, and lovely eyes that would tightly close whenever she laughed, which she did all the time. I was soon returning to Newcastle upon Tyne for less academic reasons, driving six hours up and back through murderous weekend traffic in my ancient Ford Fiesta, a banged-up piece of junk that I''d picked up for £1,100 from my first paycheck. Maureen introduced me to music.

Not the bland early-eighties glam rockers in eyeliner, hair spray, and jumpsuits such as Adam and the Ants, Culture Club, and Simple Minds that I''d been infatuated with through my adolescence, but the music that I still carry with me. Passionate music that told stories about land and history mixed with relationships and burning desire. The driving, soulful Celtic-based music of the Waterboys, Christy Moore, and Dick Gaughan. Maureen''s brother Phil, who lived in St. Albans, about forty-five miles from Cambridge, quickly persuaded me that a future without a guitar in hand was no future at all and took me to buy my first axe--a Yamaha that I still own and always will. After some months of commuting between Cambridge and Newcastle upon Tyne, I moved sixty miles south to London because that''s where the patients I was studying were being treated. I continued to work as a neuropsychologist, paid by my boss in Cambridge, and signed on for a PhD at the Institute of Psychiatry at the University of London, driving between the two cities several times a week to fulfill the obligations of both posts. It was a grueling schedule, but I loved the work.

Maureen gave up her job in Newcastle, took a position in London, and we soon bought our own place--a small third-floor one-bedroom apartment that was a short walk from the Maudsley Hospital and the Institute of Psychiatry in South London, where we both were based. As a building, or set of buildings, the institute is extremely disappointing--a sprawling jumble that lacks a physical presence to match its formidable academic reputation. My office was in a prefabricated building, or portacabin, as we call them in the UK. Freezing in winter, sweltering in summer, it shook each time the main door slammed. We were promised more permanent digs every year: the portacabins would be razed. But I would return decades later and discover, to my surprise and amusement, that there they were, probably still housing aspiring PhDs. The initial flush of excitement and romance that Maureen and I felt about moving in together was soon replaced with the more humdrum business of driving to see patients all over southern England, sitting in endless lines of stationary London traffic, searching in vain for vacant parking spots within walking distance of our home, and jump-starting my Fiesta when it decided not to start in the morning--which was all the time. Working at the institute and the Maudsley, it was impossible not to be moved by the patients: legions of depressives, schizophrenics, epileptics, and demented souls pacing the drafty corridors.

Maureen, an empathic, caring person, was deeply affected by them. She soon decided to train as a psychiatric nurse. Despite the doubtless nobility of this calling, her decision struck me as an abnegation of what could have been a glittering academic career. She began spending long evenings out with her new colleagues while I stayed home, writing and rewriting my first scientific papers, describing the shifts in behavior of patients who had had pieces of their brains removed to alleviate epilepsy or eradicate aggressive tumors. The histories and stories of what had happened to these patients once their brains had been tampered with fascinated me. One patient I worked with had minimal frontal-lobe damage but became wildly disinhibited as a result. Before his injury he was described as a "shy and intelligent young man." Postinjury he abused strangers in the street and carried a canister of paint with him to deface any public or private surface he could get his hands on.

His speech was littered with expletives. His wild behavior escalated: he persuaded a friend to hold his ankles while he hung from the window of a speeding train, a lunatic activity by any measure. His skull and most of the front part of his cortex were crushed when he crashed headlong into a bridge. By some circular twist of fate, his minor frontal-lobe injury led directly to major damage to the same part of his brain. Perhaps the most bizarre case I encountered concerned a young man with "automatisms"--brief unconscious behaviors during which you are unaware of your actions. Automatisms are typically caused by epileptic seizures that start in the temporal or frontal lobes and then quickly spread--an escalating cascade of neuronal firing that engulfs the entire brain. During these episodes, patients hang in a kind of gray zone. Their eyes remain open, and they are strangely animate and seemingly purposeful in their actions.

These usually include routine activities: cooking, showering, or driving a familiar route. Following the episode, the patient regains consciousness and often feels disoriented but has no memory of the event. My patient was a lanky youth with wild hair whom I tested for memory impairments following surgery that he had received to combat seizures. He was also the defendant in a murder trial. The victim was his own mother, strangled while she was securely locked in the house with her son. Just the two of them. The case turned on his being a martial arts expert with a history of epileptic automatisms, and he could (although the evidence remained entirely circumstantial) have killed her through a series of routine martial arts maneuvers and remained entirely unaware of this dreadful act. When I assessed his memory using what were then our state-of-the-art computerized tests, I sat near the door--a strategy I had seen in numerous TV crime dramas.

I didn''t feel safe. I needed a weapon. All this now seems ludicrous, but there I was, sitting in a closed office with a man who was accused of killing his own mother with his bare hands without even knowing that he''d done it! If he had done it, could he be judged responsible? I wasn''t sure. The thinking then and now was that automatisms, rather than expressing subconscious impulses, are automatic programs firing in the brain, completely outside our control. If he had been a carpenter, he would have been sawing a piece of wood rather than karate-chopping his mom. Could his brain make him kill again? That was the uppermost question in my mind. What could I use to defend myself? The office around me was stacked high with papers, books, and the paraphernalia of scientific investigation--not exactly an armory. Beside the desk I spied a squash racquet.

I clutched it, mulling over some vague plan to parry the young man''s blows. Fortunately for both of us the session passed without incident. I have often thought what an odd sight it would have been: the patient attacking me like a ninja while I tried to swat him about the head with a squash racquet. The work was enthralling, but all the while I was losing touch with Maureen. Within a year of buying our apartment, the relationship fell apart. We were going in different directions: me into a career in science and her into a job in psychiatric care. Something had changed between us. I couldn''t understand why she''d lost the sense of shared wonder about the brain and how it is affected by damage and disease.

I couldn''t understand the appeal of what felt like simply caring for a problem rather than trying to solve it. I''d made the decision, some years earlier, not to pursue a traditional medical career. I''d never wanted to be a physician, listening to people''s ailments and dishing out medication according to standard protocols. I wanted to try to understand the mysteries of the way our minds work and perhaps discover new approaches to treatment and cures. That''s what neuroscientists do. I thought that I had my eye on the bigger picture, but I was probably just insufferably self-righteous, driven by the ambition and idealism of a young scientist. I thought we might be able to understand and then cure Parkinson''s and Alzheimer''s diseases. I was also dazzled by what then impressed me in my naïveté as the glamour that a high-flying career in neuroscience might offer.

My boss was sending me to exotic locales to give talks in his stead. At an academic conference in Phoenix, Arizona, I found myself in a hot tub in the desert with two other English neuroscientists. Can you imagine? The day before we had all been plodding through the perpetual precipitation and dreariness of England, and then there we were, luxuriating among the cacti. I must have b.