I was reading today about the disease at the heart of the new movie Brain on Fire and thinking about what a truly astonishing race humanity is, that we can identify something this weird and then fix it. And then I thought about the picayune nature of religion and how little it has done to fix, well, anything.* You know, one of the biggest markers of modern Christianity–and one of the reasons it is eventually going to fall apart–is that its adherents are incapable of testing and evaluating their ideas in a credible way, which leads them to do really harmful things to themselves and others as they flail around with their magical thinking in hopes of fixing problems that magical thinking just can’t fix.
Brain on Fire.
The movie Brain on Fire is based on a book of the same name. In it, a young woman gets a disease out of nowhere that causes her significant changes in personality, is eventually diagnosed and treated, and slowly returns back to normal (the term here means “normal for her,” not “normal for everyone,” of course) and goes on about her life.
The disease is called anti-NMDA receptor encephalitis. Until now, I only knew that last term, but that last term alone tells me that this is going to be bad. Basically, it’s an autoimmune disease wherein the body attacks its NMDA receptors. The NMDA receptor is found in nerve cells; it controls memory function and to an extent our learning ability. Those nerve cells need to be really flexible, and the receptor allows it to activate and relax/contract as needed.
Now, a lot of stuff can affect the NMDA receptor, and it in turn has a big impact on how people feel and think. PCP, booze, ketamine, nitrous, they are effective in large part because of how they effect that receptor. Diseases like Alzheimer’s and toxic processes like over-rapid benzo or alcohol withdrawal are related as well to how those receptors work.
In the case of anti-NMDA receptor encephalitis, antibodies target NMDA receptors pretty much all over our bodies. This process is sometimes involved with a tumor. Once those antibodies get into our cerebrospinal fluid, the big damage happens. Symptoms are quite varied, and most people will likely just think they have a touch of the flu at first. Later, though, they’ll start showing the disturbing ones: paranoia, psychosis, violent behavior and ideation, agitation, and the like, which is why most of the folks with this disease first present to psychiatrists. If the disease isn’t caught then and treated, they’ll progress along to making weird “pedaling” motions with their legs, piano-playing motions with their hands, getting seizures, and the impaired cognition, speech, and memory that we’d expect from something that destroys NMDA receptors. And if it still isn’t fixed, then yes, this process can continue until its victim dies. (As an added non-bonus, kids can totally get this disease too.)
If the antibodies are there because of a tumor and the tumor is removed by surgery, that usually fixes the problem right there because the tumor was what sparked the antibodies in the first place. The usual immunotherapy stuff we do for other such diseases comes into play either way: steroids that suppress the entire immune system, IV immunoglobulin, blood filtering to physically remove the antibodies. There’s a second line that deploys for the patients who don’t improve at that point, including treatment with a drug that specifically destroys the white blood cells that are causing the problem. Recovery can take months even then, and weirdly, the symptoms will reappear in reverse order and then fade. Afterward, the patient’s social behavior and memory/learning functionality return. It’s slow and confusing and scary.
Sportsball enthusiasts might remember that the Dallas Cowboys defensive lineman Amobi Okoye suffered from this disease in 2013-2014; he’s back in play now (with another team, the Roughriders), but it took a year and a half to defeat it. Part of his recovery required him to be in a medically-induced coma for a few months. And Knut, the polar bear that died back in 2011, died when he drowned during a seizure caused by the disease. So it can affect both animals and people.
We’ve only just begun to work on this disease. It’s relatively new, having been categorized and named only since 2007, but obviously it’s existed for longer. Even after 2007, very few people with the disease were correctly diagnosed.
Science. It Works.
I can only imagine what it must be like to suffer from this baffling constellation of symptoms and then come into the full power of the modern medical system and its dazzling array of drugs that target tiny parts of cells that the sufferer didn’t even know he or she had, and then be guided through a recovery that all by itself seems like a second death sentence before returning to their lives.
The young woman at the heart of Brain on Fire, Susannah Cahalan, suffered from misdiagnoses like “partying too much” and schizoaffective disorder, even bipolar disorder, before she finally ran into a doctor who suspected she had this new disease, anti-NMDA receptor encephalitis. After diagnosing her correctly (she was the 217th person ever diagnosed with it), he got her into treatment for it. By that time she was having psychotic episodes and sliding into catatonia, so she ended up hospitalized. When she finally awoke from the worst of it, she didn’t even remember that last month.
If you’re asking yourself, like I did, what religious leaders would have done with a case like hers, there may be an answer for that question.
In the 1970s, a young German woman named Anneliese Michel began having seizures and strange outbursts and hallucinations. Medical treatment didn’t appear to be doing anything at all to help, so her family–certain she was possessed by demons–appealed to the Catholic Church for an exorcism. In fairness, the specific symptoms she experienced did sound like the textbook definition of a movie-style possession: she saw demons, heard voices declaring that she was damned, and became increasingly hostile toward religious objects and places.
In 1975, two priests got to work on her. They did one or two exorcisms on her a week, 67 in all, each session lasting up to four hours, though none of them seemed to “take.” Eventually, she died, with the priests claiming that the last exorcism had finally freed her from the demons’ control. Afterward, authorities learned she’d been quite malnourished and dehydrated, which led them to charge both the priests and her parents of negligent homicide (they got six months’ imprisonment, which was suspended, three years of probation, and a fine). At that point the Catholic Church decided that she’d actually suffered a mental illness, not possession, though her grave still became a pilgrimage site.
Now some folks think she might have had the same disease that Susannah Cahalan had, which is why none of the psychoactive drugs she was given worked for her.
Whatever was wrong, it sure didn’t get better with all the attentions of professional Christians. Hence why I join Richard Dawkins in saying of science: “It works, bitches.”
Oppression or Possession?
In fact, this disease may well be responsible for many cases that are considered by Christians to be demonic possession because of its weird, unnerving psychological manifestations and its sudden onset in someone who seemed healthy beforehand. It’s a relatively common disease–it accounts for about 1% of all ICU admissions in young people. (That paper specifically suggests avoiding the high-potency anti-psychotic medications, incidentally, which poor Anneliese Michel took until shortly before her death.) Certainly it’s still misdiagnosed as a mental illness sometimes.
Strangely, however, “Jesus” never told any of those Catholic priests–or any other Christian for that matter–what was really going on. One wonders how many of the victims Bob Larson accosts with his exorcism nonsense are really in the first stages of this form of inflammation.
Mental illness in general doesn’t appear to be fervent Christians’ first thought when presented with symptoms like the ones Anneliese and Susannah had. Christianity Today and Charisma News both offer tips for spotting and “freeing” people who are being oppressed or controlled by demons, with Charisma warning that because “we live in a fallen world,” people can sometimes just be sick–but that even then, “we have been given dominion over everything that moves, including those living creatures that we cannot see with the naked eye.” In their estimation, that means that if someone’s sick they might not necessarily be outright possessed, but might instead just be oppressed with disease by a demon. Meanwhile, Christianity Today has their guest exorcist explaining exactly how he coaches his victims to respond to him and then leads them through guided imagery to rid them of their “demons.”
Seriously. Nobody’s ever even gotten any credible confirmation that demons even exist, but Christian groups are still out there fighting the good fight by drawing clear lines between different kinds of demonic influence and giving breathless tips on how to fight it. And Charisma’s checklist for demonic possession, written by “a prophetic healing evangelist” with no experience, education, or training in psychology, sounds very much like it could be describing anything from “a normal teenager being a teenager” to “anti-NMDA receptor encephalitis.” (Don’t miss the comments–the readers got very busy arguing among themselves about the differences between possession and oppression, with a few hardy souls trying to make the case for evidence-based medicine instead of medieval chanting and rituals.)
When someone with a real disorder presents to one of these TRUE CHRISTIANS™, the results are not going to be pretty–and the resulting failure is going to be ascribed to the person suffering, not the charlatan swanning around with their bottles of oil and their rituals.
Aw, What’s the Harm?
When someone asks, “Aw, what’s the harm of believing something that isn’t true?” cases like these come to my mind immediately. I’m thankful that Susannah Cahalan didn’t leave treatment to go find an exorcist to help her, but instead put her trust in reality to get her cured. I’m sorry that Anneliese Michel withdrew from reality to seek help from those charlatans of religion, who couldn’t turn cream into butter with all their chanting. And I’m angry that even today, those same charlatans ply their trade among ignorant, gullible Christians, who may well rely on this “care” instead of seeking real help for their problems.
That’s the harm: that ignorance will lead someone to magical thinking, and thus to harm because they’re not taking advantage of modern medicine when they get sick, and that worse yet they will subject their children to this harm.
The punt to mystery of “a fallen world” isn’t satisfactory either. “Demons did it” is no more an explanation than “‘God’ did it” might be. The notion that the totally-ignorant misstep of two totally-ignorant humans could cause all this suffering is so monstrous and evil that I don’t think Christians are really thinking through what that tortured illogic really means–and so patently ridiculous that no reasonable person could accept it as the reason why lions eat meat any more than it could explain why brains set themselves on fire.
That inability to follow their own ideas to their logical conclusions is, itself, part of the harm that religion does. I’d rather put my faith in the scientists who refuse to rest in “Oh, welp! Guess that’s another consequence of the Fall!” as a reason for anything. At least their questions lead to real answers and real solutions instead of deaths and needless suffering for the many people who develop real problems that chanting can’t fix. But lifting suffering isn’t the goal here. Perpetuating the broken system is the goal. And so we will not see an end to religious interference in medical matters anytime soon.
Next time we’ll be looking at hypocrisy in Christianity–the similar inability that so many of the religion’s adherents have to live by their own religion’s dictates.
* This is how I think; my writing process looks remarkably similar to Fucking Around Online in My Pajamas Until Something Catches My Eye. I doubt Hemant does it that way, but it seems to be working for me. It was what led me to the topic we’ll be talking about next time–see you then!