19. Risk Factors

"What we are really talking about here," said Doctor Trilling, "is madness."

Joe Funk held his breath.

"Now no one would deny that people do go mad. People have always gone mad and will always go mad. And they will do it in as many different ways as there are minds. My colleagues," Trilling chuckled, "like to make grandiose comparisons between the human brain and the stars of a galaxy. They like to point out that it is the most complex and complicated and intricate system known in the universe. Trillions of cells working together, somehow, to achieve a common purpose. A common purpose that we call, in our ignorance, 'consciousness,' and leave it at that. Very well. But what I like to point out is that the most complex and complicated and intricate system known in the universe is bound, occasionally, to malfunction. And to malfunction in the most complex, complicated, and intricate of ways. No two madnesses are quite alike. And so is it any wonder that congephrenia has given us diagnosticians such trouble over the years? It's why even today we cannot seem to come to any consensus as to what exactly it is. Oh, we know it when we see it, alright. But it's easier to recognize than it is to define."

Joe Funk must have smirked, for the Doctor seemed to read his mind:

"That's not as ridiculous as it might sound. After all, you are a policeman, you—"

"Retired," Funk corrected him. "I'm a freelance operator now."

"I beg your pardon. As a former police officer, though, you can surely affirm that it is a lot easier to recognize someone than it is to describe someone's appearance—to a police artist, say. And you would never apprehend and convict a criminal you had identified merely from a police sketch if you could get the original witness to identify them in person, would you? Well then." Trilling laced his fingers across his substantial belly and leaned back in his chair with an air of self-satisfaction.

Funk waited for the man to go on.

"The point I wanted to make was that we know madness when we see it, though we don't always know how to categorize or name it. Indeed, from what I had just said you may perhaps even have received the impression that I do not believe madness can be classified. If so, you are correct. How can you group and label that which has an infinite number of possible manifestations? How do you gather together under a common heading something of which no two instances are alike? Hm? The answer is: You can't. You don't. But this is a contentious point. My colleagues," Trilling chuckled, "disagree. I am in the minority opinion here, alas. Which is why even today we still see the rampant fragmentation and subdivision into sub-categories of sub-types of this disease. But this is only the trough—or the peak—of the wave. In a few years, no doubt, when I am dead and gone, no doubt, someone will become fed up with the splintering and decry it; some young zealous crusader will give madness a new name—as I, in my youth, gave schizophrenia a new name—and bring together again all the shards, reunite again under one banner all the discrete factions. And then, of course, the fragmentation process may begin anew. And so forth and so on. It's an old story."

Mike's characters seemed to like to make speeches as much as Mike himself did. Drew flipped forward a few pages.

"But that's exactly why so-called mass congephrenia is such hogwash," Trilling cried. "You can't transmit madness from one person to another. It's too complex, too idiosyncratic, as complex and idiosyncratic as the personality or the mind itself. Madness can't be contagious. It's like suggesting that character types, or upbringings, or IQs are contagious. It's impossible! Just because you find two people have the same mad ideas doesn't mean they're two mad people. If anything, it should lead you to conclude that at most one, and possibly neither of them is mad. Because true congephrenia is unique. Each congephrenic spins his own personal psychosis out of the materials available to him. It's like building a sort of mental nest. And congephrenics don't share nests. By definition a psychosis is a view of the world that simply does not correlate with the common, accepted, consensual reality. By definition a congephrenic is someone whose ideas about the world do not match anyone else's."

"But the doctor at the hospital," Joe Funk interrupted, "I forget her name, but she said something about Vanessa having a, what was the word, a genetic predisposition to this, to this, to congephrenia ..."

Drew glanced again at the back cover.

Hailed by critics around the solar system as "ferociously brilliant" (SF Log), "chillingly challenging" (Newsday Japan) and "aggressively thought-provoking" (Chapel Falls Sentinel), science-fiction mastermind Michael E. Lipp returns with another darkly stunning and fearsomely bone-tingling tale of murder, madness, conspiracy, robots, and sex—a tale of Mass Congephrenia.

The year is 2065. In the newly-renamed United American People's States, it is a time of hardship, paranoia, and despair. Joe Funk, a down and out ex-policeman—a one-time hero forced into early retirement under a mysterious cloud of scandal—now works as a "freelance operator," or private dick. Barely able to make ends meet, rubbing elbows with the scum of the earth, and addicted to Breaze (the expensive, "non-addictive" prescription medication substitute for alcohol, which has again been prohibited), Funk's life is in a shambles.

But when his wife Vanessa is diagnosed with an abstruse new ailment called "mass congephrenia," and is taken, against her will, to a "mental rehabilitation center," things go from bad to worse—and really begin to get strange.

Vanessa. Not his daughter but his wife. But still, the similarities were striking, even spooky. The name. Vanessa. Miranda. Three syllables, stress on the second. Both ending with an "a." More than that: the same number of consonants and vowels. And in the same position:





Alright, it was just a coincidence. But still.

He flipped back to Joe Funk, who was still spluttering, "And that for people with a genetic predisposition to certain paranoid patterns of thought, for someone with a sort of weakness for these ideas of persecution and conspiracy ... Well, to someone already predisposed to thoughts like that, certain paranoid conspiracy theories, like the ones those idiots were drumming into her, the ones she was reading about, all the mind-control machines and the chemicals in the rainwater and all that stuff, to someone like her those ideas could be dangerous. Were dangerous; had been dangerous. According to this doctor, these were the triggers. It was those crazy ideas that had, you know, broken the yolk."

"First of all." And the doctor paused long enough to make Joe Funk think that this was going to be a long list indeed. "First of all, this notion of a predisposition, genetic or otherwise, is nonsense. You don't need me to tell you that. All you have to do is think about it a little bit critically and you'll see that I'm right. If you can't tell who has this predisposition, if you can only say who had the predisposition after the fact, after they develop the disease, then you can see that the notion is meaningless. Granted, there is a genetic component. What that means is simply that the children of congephrenics are at a slightly elevated risk compared to the children of non-congephrenics. Or, to be even more precise, it means that on average a slightly greater percentage of all the people whose parents had congephrenia will themselves develop congephrenia, compared to the percentage of all the people with normal parents who get the disease anyway. If your mother or your father or another relative had the disease, you might have a three or four percent chance of getting it yourself. Okay. But if you're human, period, you've got a one or two percent chance of getting it, some form of it, at some time in your life. Statistics, you see. Abstractions." The doctor waved his hand above his head like a conjurer. "To say 'My parents were congephrenics, therefore I have a greater risk of becoming congephrenic myself' is something of a fallacy, an error of misplaced concreteness. And to go further and conclude that because your parents were congephrenics you have some sort of genetic predisposition, some actual flaw that makes you more susceptible to insanity, as if your mind were an egg that had come out of the carton cracked—well, that's just fiction. We've never seen a crack. Maybe there are cracks, maybe there aren't. Right now our eyes aren't acute enough to see. All we can see is a lot of shells, all of which seem to be whole and intact, and most of which seem to walk around their whole lives that way—until they crack open. Until the yolk breaks, to use your phrase. We try to understand why some eggs break open and others don't. My colleagues say, well, obviously, all the eggs that broke open must have had a crack—a predisposition to breaking. But you can see that that's just foolishness. There's no way to prove or disprove that such a thing exists.

"Let's look at it from another angle. This doctor talked to you about 'triggers.' Another meaningless concept. Somebody notices that every once in awhile an egg put into boiling water, say, breaks open." Trilling paused and looked at Joe Funk shrewdly. "You understand that when I talk about an egg breaking open I am using a metaphor for the development of congephrenia? Good. Alright. So. Someone notices that one in a hundred or one in a thousand eggs put into a pot of boiling water break open. Why do these ones break open and not the others? Because of the little crack in the shell (which we can't see but which they conclude must have been there all along). But then someone else notices that one in a thousand eggs tossed up in the air breaks open when it is again caught. You understand these are metaphors for different putative triggers, yes? I am not suggesting that congephrenics or proto-congephrenics are literally tossed up in the air. Very well. So some other activity—it doesn't matter what it is, rolling the eggs down a hill or tossing them up in the air—is also found to cause, or enable, or facilitate the breakage in a small percentage of eggs. What is the explanation? The same: that the eggs that broke must have had little cracks all along. But someone points out that some of the eggs that have broken by being tossed into the air had already survived boiling water. If they were cracked, why didn't they break when they were boiled? The facile answer that my colleagues," Trilling sneered, "in their overpriced textbooks give is that boiling water, being tossed in the air, and rolling down hills are not causes of broken eggs, but mere triggers—or better yet, risk factors. They increase the likelihood of breakage, but do not guarantee it. They are risky behavior for eggs with cracks, but you will never know if you have a ... Oh, to hell with eggs! They want to say congephrenia is caused by a genetic predisposition, but they have to admit that not everyone with this predisposition develops the disease. They want to say congephrenia is caused by these triggers, but they have to admit that not everyone who develops the disease has been subjected to these triggers; and vice versa, not everyone who is subjected to them develops the disease. They are reduced to the very paltry conclusion that neither the predisposition nor the trigger alone, but the two of them together, cause congephrenia—and then not always."

"Okay," said Joe Funk, "but ..."

"Alright, alright!" cried the doctor, waving his hands as if sweeping away disorder. "You want to talk about triggers, about risk factors? Of course there are triggers. Of course there is behavior that is dangerous to mental equilibrium. Of course there are things that can prompt, or anyway seem often to precede, the onset of mental illness. Fasting, meditation, sickness, and drugs can all fuck with your brain chemistry. So, for that matter, can any number of psychological occurrences. Extreme experience of any kind can throw the mind out of homeostasis. A drastic change in financial circumstances, immigrating to a strange land, being fired, getting a new job, falling in love, being rejected by a loved one. A divorce. A wedding. The death of a loved one. All these things can make the brain go haywire with stress, with disorientation, with emotion. In fact, if you're going to talk about risk factors, let's leave it at that. Let's say that stress of any sort, disorientation or confusion of any sort, and extreme emotion of any sort are the risk factors for madness! Let us say that life itself, life fully lived, is a risk factor for madness! Do you feel things? Do you breathe? You do? Ah, then I regret to inform you that you have a genetic predisposition to congephrenia. If you do not want to go crazy, you should avoid cigarettes, pills, good food, bad food, song, laughter, beauty, human relationships, novelty, hardship ... And whatever you do, be sure you don't listen to any conspiracy theories."