A glimpse towards the future

If you were suffering from a terrible neurodegenerative disease that could be cured by removing carefully chosen sections of the brain and replacing them with a prosthesis, would you want the surgery to go ahead? What about if this was happening to a person you loved? What if the 'cure' meant losing all memories from the last 20 years?

This is the dilemma facing married couple Carrie (Barbara Flynn) and Lorna (Zoe Wanamaker) in Nick Payne's new play, Elegy, which opened at the Donmar in London on 27 April. Set in a near future where the brain has been fully mapped and can be rebuilt and modified, this compelling drama explores some profoundly important philosophical, ethical and moral questions. The set is simple and effective, the music perfectly chosen, and the acting brilliant.

Payne's close collaboration with neuroscientists was strikingly evident in some places, with the doctor (Nina Sosanya) reeling off sentences that were packed with accurate terminology and believable mechanisms. In fact, such was the enthusiasm and speed with which these lines were delivered, that at times it felt a little contrived and unnatural. And while the effects of amnesia rang true in many ways and were very movingly portrayed by Wanamaker, the compartmentalised nature of the memory loss and apparent lack of implicit memory was not entirely consistent with current neurobiological understanding. Nevertheless, Flynn's response to the changes in her wife was heartbreakingly real and a very true reflection of what is commonly seen in traumatic brain injury and memory clinics.

Overall, although there were one or two elements that jarred with my clinical experience, I found the play gripping, thought-provoking and well informed. The controversy surrounding psychosurgery is not a new one but with this glimpse towards the future, Elegy takes it to a new and potentially sinister level. The questions surrounding how and when we should intervene in the natural interplay between nature and nurture are ones that will become more and more prominent as the field of neuroscience continues to shed light on the links between brain and mind. 

-       Elegy is on at the Donmar until 18 June.

-       Dr Catherine Loveday is Principal Lecturer at the University of Westminster. She discussed the play with Claudia Hammond on the latest edition of BBC Radio 4's 'All in the Mind'.