She wasn’t on PCP, but her own body made her hallucinate

Stories of the hijacked brain
By Sara Manning Peskin

On an ordinary day in August 2016, Lauren Kane was sucked into a zombie apocalypse. The recent graduate and aspiring fiction writer had moved back into her mother’s house; she spent her days brushing up on short stories and binge-watching episodes of “The Walking Dead.” That morning she had woken up, had breakfast, and gone back to bed. “What’s breakfast?” she asked when she reappeared. Lauren slept more and woke up for the third time around noon. “What’s breakfast?” she asked again. By that evening she had a fever and had become unsteady on her feet. Her mother took her to the emergency room, where Lauren calmly answered a doctor’s questions. In her first book, “A Molecule Away From Madness,” neurologist Sara Manning Peskin describes what happened next.

Suddenly, as if possessed by a ghost, Lauren reached for the doctor’s chest and grabbed his shirt. She pushed him across the room, then dug her fingernails into the arm of a startled nurse. Her mother moved to calm her, but Lauren pushed her to the floor.” Security guards rushed to the spot. Lauren turned and pointed to one of them, yelling, “Can’t you see, she can walk.” One guard asked if she was high on PCP, while another pieced together the patient’s pop culture reference, “Oh my god. … She thinks she’s in ‘The Walking Dead.’

Lauren wasn’t taking phenylcyclohexylpiperidine, the hallucinogen known as PCP, but her own body produced a molecule that had a similar effect. A tumor growing on her right ovary had stimulated her immune system to produce millions of antibodies, which accidentally attacked crucial receptors in her brain. Lauren was the victim of a runaway molecule.

Such errant molecular activity underlies many serious mental illnesses, notes Peskin, an assistant professor of clinical neurology at the University of Pennsylvania. “The molecules that make our brains work can also take over our personalities and destroy our thinking abilities,” she writes. (After Kane’s tumor was surgically removed, she slowly regained contact with reality.)

The author divides these “molecular villains” into four categories. “Mutants” are altered DNA sequences; they can give rise to conditions such as Huntington’s disease and frontotemporal dementia. “Rebels” are aberrant proteins, like the one that caused Kane’s psychosis; they can lead to plagues such as Creutzfeldt-Jakob disease, a neurodegenerative disorder that is inevitably fatal, usually within a year of onset. “Invaders” are foreign substances such as “environmental toxins, illegal drugs and pharmaceuticals”; they can cause pathologies such as mercury toxicity. And “evaders” are essential components, like vitamins, that wreak havoc when they go missing. For example, a thiamine deficiency can lead to the development of Korsakoff’s syndrome, a symptom of which is confabulation: sufferers make up fantastic stories and think they are true.

Peskin writes about these ailments and the patients consumed by them with a grace and humanity reminiscent of Oliver Sacks. Her thin tome also manages to tell the stories of the doctors and researchers who hunted these insidious molecules in the field and in the lab; she has a flair for the quick character sketch and an eye for lively details.

The only person left out in this compelling report is the author himself. It is only in a footnote to Lauren Kane’s story that we discover that she was Peskin’s patient; the main part of the story is told from an artistic distance.

Kane’s doctor is a dazzling stylist and a compassionate observer. In her next book, she may show us more of what goes on in her own head.

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