The Psychoactive Café (4 page)

Miguel and Chenko didn't have the
same workload intensity, but their role was equally important. They were
designing a communication strategy to flood the world with information about
the device before it could be censored. Their plan was to upload all of the
fabrication software and instructions in a zip file onto multiple BitTorrent
sites simultaneously, a few hours before launching a world-wide media campaign.
I’ll describe that more later.  

It turned out that Chenko had
been thinking about these issues for years. He’d come here looking for people
like us, investigators into the neural interfaces of pleasure. He had a
mission. He’d even learned table tennis as a way to infiltrate nerd culture. I
don’t know why he had devoted himself to this; he never talked about his family
or his background. From his name, he sounded Ukrainian - though it was a
nickname, like Junior, he said - but he came from somewhere in Russia. It was like he’d been preparing to live in hiding all his life.

Naseer, unfortunately, wasn’t
hard to understand. I disliked him more and more as we went on. He wanted to
disseminate the fabrication file immediately. Without the international heroin
trade, Naseer figured, the Taliban would collapse, the Americans would leave,
and Afghanis would have a chance to take back their country. He didn’t give a
damn about the health risks for people who would use the device. As far as he
was concerned, drug users were garbage, and they didn’t deserve human rights.
He sounded exactly like the American right-wingers who shut down harm reduction
programs because it was better for a thousand drug users to die than to risk
the purity of one of their precious children. Chenko didn’t even bother to
argue with Naseer, and I stopped arguing with him when I realized that if he
got too angry, he would release the instructions himself.

The composition of our little
team was not optimal. We were missing expertise in policy, law, economics,
bioethics, and international relations, to name some of the obvious gaps.
Chenko talked me out of recruiting anyone else. First, it would mean
implicating them in something that might destroy their careers, if not risk
their liberty. Second, if they reported us and the project was shut down
prematurely before testing was completed, it would result in harm to the users
of the device. Miguel had worked out an emergency dissemination process that
could be launched within a few minutes, automatically uploading the most recent
stable design release with explanatory material at the same time as sending out
canned announcements to dozens of sites. At any time, any of us could start the
upload process, even if we weren’t completely ready. We were all scared that
Naseer would have a tantrum and launch pre-emptively, so we tried not to annoy
him.

Xiang was determined to develop
the safest, most effective device possible before releasing it, and that’s what
I devoted myself to. We were spending every available waking moment together –
actually, I should explain that. We didn’t really have to spend every minute
together. I could do most of my analyses alone. It was more that we were both
terrified about what we were doing… no, that’s not quite right either. Okay, I
admit it. I was already nuts about him, had been for months. He was the most
interesting person I’d ever met. He was brilliant, of course, and totally
focused on his work, but he also had the courage to see the implications of his
actions.

I could go on, but I won’t. He’s
hard to get to know because he’s usually concentrating on his research and
doesn’t notice humans all that much. But I wooed him with beautiful reality crystals
in the form of analyses he hadn’t thought of and, eventually, he asked, with
endearing shyness, if I had a boyfriend.

A few weeks later, I asked Xiang
to marry me. We were waking from an afternoon nap in his apartment, and we’d
both been staring at the ceiling in silence, him thinking and me working up the
courage to askI popped the question. He rolled over to face me, and said, “For
love, Julie?” I laughed, because of course I was in love with him. Working with
him was like being high all the time, but it was a dumb question.

“Yes,” I said, “only for love.
I’m a romantic fool. It has nothing to do with the Chinese legal system.” He
laughed then, too. To make a long story short, we married a fortnight later in
the Caribbean room. Mom was totally pissed off, but she came to the wedding and
relaxed a bit when she saw how happy I was and how Xiang looked at me. Not that
either of us was pretty, what with weeks of sleep deprivation and bad food. She
asked why it was called the Psychoactive Café, and I told her it was because it
served coffee and beer, of course.

What did we wear to the wedding?
We washed our clothes for the occasion if that’s what you mean. We weren’t
going to waste time shopping.

We were all starting to think
about our post-launch careers.

For this device to have
scientific credibility, it had to have Xiang’s name on it. I was contributing
to the development, as was Naseer, but Xiang was definitely the lead. We
decided by consensus that I’d be named on the press releases because, as Xiang’s
wife and collaborator, there was no way I could hide my involvement. Everyone
else would be anonymous. They would be identified sooner or later, probably
sooner, but there was no reason to make life harder for the team than it needed
to be. We would also credit Xiang’s other research collaborators, while
distancing them from the decision to go public. For Xiang, this was the worst
part of our project, to steal the intellectual property from his colleagues.
Chenko soothed, cajoled, and assured Xiang that the official owners of the
device would make a fortune, that anyone who could buy it legally would do so
through regular medical channels, and that what we planned would be a massive
freemium campaign to drive profits to the legal devices. Xiang wouldn’t talk
about it, though. He just worked.

For myself, I felt sick about
the project every day. To publicly release the design of a powerful medical
device that hadn’t been approved went against all of my training. Early medical
technologies are never optimal. We knew that people would die as a direct
result of our actions. There was no way that every single back-alley
electronics lab would fabricate it with adequate quality controls, and there was
no way that Xiang’s mapping would work for everyone. We could count on
seizures, hallucinations, depression, mania and suicides among the potential
side effects.

So I got more scared as we went
on. And all the time Chenko was driving us, cajoling, encouraging, and coming
up with answers to all of our objections.

Objections like: Even if the
device worked exactly as it was supposed to for everyone, which wasn’t possible
– no medical intervention is risk-free – would it damage future generations of
kids? Teenagers’ brains are still developing, and they are particularly
vulnerable to brain insults, as well as being susceptible to sparkly, new
intoxicants. How would continuous stimulation of pleasure centres affect the
wiring of their brains? It would almost certainly have an impact on the way
neurotransmitters developed, how could it not?

Would it destroy people’s
ability to live normally? There’s plenty of evidence that other drugs,
including nicotine and MDMA, actually reduce users’ capacity to experience
pleasure, making them dependent on the drugs to get a normal buzz out of
living. Would there be permanent effects even after people had quit using it?

How easy would it be to kick the
habit? In developed countries, most illicit drug users drop their consumption
of illicit drugs by the time they ’re thirty, and move on to alcohol and other
legal buzzes. Would it be harder to kick the device than to kick, say, heroin?
And could the device be designed to facilitate withdrawal if people wanted?

Would it be so tempting that
anyone with a pain problem, meaning everyone in the world at least some of the
time, would use it and get hooked?

Or even scarier. Could it be
used to control populations, to give governments and prisons the ability to
keep people docile on a large scale?

To all of these questions,
Chenko kept responding with the same script: “Everyone’s life has the same
value, and everyone should have control over their own lives. The war on drugs
is based on an assumption that some people’s lives have more value than others.
If everyone faces the same risks related to drug use, societies will invest in
solutions that will help everyone, not just the people who can afford the most
expensive drugs. Our device will be less dangerous than glue-sniffing or street
heroin.”

He’d get into details, of course.
I remember him saying to Miguel, “Look, don’t be so naïve! It’s normal for
anyone to care more about their own kids than other people’s kids. It’s the way
humans are made.”

In other words, when laws are
made and enforced, and when research is funded, and when markets are regulated,
the children of the powerful are unlikely to be the unintentional victims. The
children of the powerful are not the ones who get stopped by the cops because
they look suspicious, so even when they are carrying drugs, they’re not going
to be caught. If the powerful somehow discover that their own kids are
‘experimenting with drugs,’ they certainly don’t call the cops on them because,
my goodness, we wouldn’t want their lives to be ruined. Poor, you go to jail;
rich, you go to rehab.

I’m sounding like Chenko now,
but you get the idea.

As I said before, I took on the unofficial
role of calculating the health risks of the device. I had to be absolutely sure,
at least in my own mind, that we were doing the right thing.

My first step was to choose one
primary indicator for health impact that could apply to everyone in the world. In
other words, how could I measure health risks and benefits of the device across
all countries and all income levels, and not treat people in developed
countries as having more value than people in less-developed countries?

I chose Disability-Adjusted Life
Years, or DALY, which the World Health Organization uses for just this purpose
– to equalize the global calculation of life-worth. DALY measures the number of
years lost to ill-health, disability, or early death.

DALY assumes that everyone in
the world has the same potential years of healthy, disability-free life. The
DALY for an Afghani five-year-old who can't get enough to eat because food
crops have been replaced by heroin is a lot worse than the DALY for a Canadian sixteen-year-old
who drops out of high school because he smokes dope every day.

DALY weightings are kind of
subjective because someone has to assign severity indices to different
disorders. What was worse, dropping out of school or malnourishment? But they were
the best thing we had to work with, and policy wonks had been refining the
weightings for years.

Then I adapted the DALY to
include deprivations of liberty. Chenko’s position was that people have a
fundamental right to control their own bodies without being subject to violent
penalties from the state. If you ’re jailed for drug use, that’s at least as
disabling as being restricted to a wheelchair. Losing your job or your kids can
be converted to disability weightings too. I fiddled with various weightings to
reflect different levels of severity, like losing your job is worse than dental
cavities but not as bad as blindness. As you can imagine, it was pretty crude,
and I bracketed the DALY definitions and ran them every which way. Still,
having one overall indicator let us quickly model various scenarios of
potential harm. 

So this is how we modelled the
risks.

First, I broke down populations
into age groups, gender, household income, nationality and a few other
categories. Then we broke them down by the estimated number in each category
that currently used heroin, cocaine, cannabis, alcohol, tobacco, other
regulated drugs, and no illegal drugs, based on credible population surveys.

Then I created various five-year
scenarios. Like in one scenario, I assumed that ninety percent of the heroin
users would switch to the device, but only fifty percent of the casual cannabis
smokers would switch and thirty percent of the heavy drinkers. I created
hundreds of scenarios and ran them through different DALY weightings, including
indirect effects like the differential risk of injuries and deaths.

The device simulated several
different types of intoxication, so I made pessimistic assumptions, assuming
lots of people would crank up their devices to ‘full opiate’ settings and die
of starvation, and that lots of drivers would use ‘moderate cocaine’ settings
and get into traffic accidents. Even with the latest data mining software, it
took me hundreds of hours to run the analyses and reflect on the implications
of the patterns. That wasn’t something I was trained for; I had to feel my way.

 Then I assumed worst cases for
the device itself, like a higher-than-expected percentage causing it to become
defective and not shut off properly, or the implants migrating to the wrong
places, or people having seizures, and so on. What were all the ways that this
device could kill someone, and how likely was each risk? This was all based on
our best guesses.

No matter which way we ran the
models, the death rate was lowest if we released the device as soon as it was
effective for at least sixty percent of users with a serious complication rate
of less than three percent. That was a very high complication rate, by the way,
much higher than would be acceptable for most medications, but we were
competing with street drugs and gun violence.

Chenko lost interest after the
first few data runs and began to just walk away when I talked about it. Naseer
didn’t give a crap about the health of anyone but Afghani non-drug-users, and
Miguel would say, “Yeah yeah, heard that, got the t-shirt, move on.” Xiang didn’t
say anything at all, being in emotional lock-down mode.