A new production at Everyman Theatre explores a fascinating (if controversial) real-life neurological syndrome that potentially could throw into doubt common assumptions about how our personalities get formed.
Playwright Deborah Zoe Laufer wrote the script for “Be Here Now" after listening to a podcast about Geschwind Syndrome, a cluster of behaviors that can accompany a diagnosis of temporal lobe epilepsy. Among other things, formerly taciturn patients can become chatterboxes whose conversation meanders in stream-of-conscious fashion from topic to topic, while lifelong skeptics can become profoundly religious.
Sometimes, the changes are permanent and intensify over time — which can be deeply unsettling for patients’ family members and friends.
“Most of my plays ask questions about who we are as people,” Laufer said this week during a rehearsal break in the troupe’s Green Room. Previous plays have navigated the blurry line between the virtual and real worlds (‘Leveling Up”) and the ethics of genetic research (“Informed Consent.”)
“What is the essence of what it means to be human? Are our personalities just a bunch of chemical and electrical impulses, or are we more than that?”
Laufer also directs this production, which cloaks its most serious questions in the guise of an at-times light-hearted romance.
Katy Carkuff, Shubhangi Kuchibhotla and Beth Hylton in a scene from "Be Here Now." Courtesy of Everyman Theatre.
Bari is a chronically unhappy woman in early middle age who is battling the writer’s block that prevents her from finishing her doctoral dissertation on nihilism.
She has recently begun suffering from severe headaches and seizures. But these alarming medical occurrences also trigger moments of ecstatic happiness. For the first time, Bari experiences a sense of cosmic connection. She opens up to co-workers at her warehouse job and begins to date a local artist. Fearing that Bari’s life could be in danger, friends urge her to see a doctor. But, she’s not sure she wants to be cured.
Bari will be performed by Everyman ensemble member Beth Hylton, while original company member Kyle Prue returns to the stage for the second time in 13 years as Bari’s boyfriend, Mike, who is attempting to recover from his own tragic past.
“The play asks the question about where our capacity for joy comes from,” Laufer said. “Is it just chemical or electrical impulses, or is it more than that? And if we don’t naturally have joy, do we have a moral obligation to seek it out?”
Scientists say that epilepsy is a disorder of the central nervous system caused by a burst of abnormal electrical activity in the brain. Sometimes, the whole organ is bombarded with electrical impulses. At other times, the discharge is confined to just one area inside our skulls, such as the temporal lobe.
“The temporal lobe plays a role in emotion and in the coding of life experiences into memories that allow us to function,” said Peter Crino, chairman of the Department of Neurology at The University of Maryland Medical Center and at the University of Maryland School of Medicine.
“It’s part of the limbic system that governs drive states in animals and humans such as eating food and finding a mate. Chronic abnormalities in the temporal lobe can lead to a change in behavior in some people.”
It was neurologist Norman Geschwind who first noticed that patients with temporal lobe epilepsy exhibited several idiosyncratic behaviors. He began publishing his observations in the 1970s.
Some patients, Geschwind found, had a compulsion to write or draw (“hypergraphia”) Others became obsessed with religious or spiritual matters and in some cases, converted to a different faith (“hyperreligiosity”.) Some patients lost all interest in sex, though a handful became preoccupied with it (“atypical sexuality”). Some patients became motormouths who were obsessed with minutiae (“circumstantiality”).
“These patients can be kind of intense and get lost in the details,”said Gregory Krauss, a neurologist at Johns Hopkins Medicine. “They can’t see the forest for the trees and have a hard time gaining perspective.”
Finally, Geschwind described patients who seemed to have what he described as an “intensified mental life” that took the form of heightened intellectual and emotional responses.
Epilepsy can be documented scientifically, since the abnormal brain activity shows up on EEG recordings, Krauss and Crino said. But Geschwind syndrome cannot be verified scientifically, since the behaviors the pioneering neurologist described are purely anecdotal.
“I will say this about Geschwind’s observations,” Crino said. “They can be quite on point for some patients. We ask patients with epilepsy to fill out a seizure diary. Some will come in with four Moleskine notebooks in which every page is filled margin to margin."
Yet, some epileptic patients exhibit none of the behaviors Geschwind chronicled. Others may display one or two fragments of attributes. The traits that Crino and Krauss have noticed recurring most frequently are hypergraphia and circumstantiality; Crino said far fewer of his patients experience a religious rebirth.
“Geschwind syndrome is pretty controversial,” Krauss said. “Most neurologists would say that you will find parts of it in some individuals. But as a personality syndrome, it doesn’t exist.”
In addition, many of the behaviors that Geschwind identified can be explained by causes other than the disorder itself.
“It’s been shown that virtually all the medications we use to treat epilepsy have decreased libido as a side effect,” Crino said.
Like many real-life patients with epilepsy, Bari experiences the auras that can be a warning sign that a seizure will soon occur. She perceives her hands as being surrounded by swirling colors, and she thinks she detects a burning odor.
“I started writing the play after I listened to a podcast of someone who used to have Geschwind syndrome,” Lauffer said.
“She talked about how she had lacked a belief in religion before she became sick. Then she started having these seizures and suddenly her life was completely different. She had visions and she had joy. Her doctor told her it was a tumor that had to be removed. She had the tumor taken out — and said in the podcast that she has regretted her decision every day since then, because she cannot feel any more what she felt before the surgery.”
Crino and Krauss said the account in the podcast differs from their experience treating patients.
“When you remove the temporal lobe in patients with epilepsy,” Crino said, “it cures them 70 percent of the time. People often feel better. Their memory and cognition improve and so does their general mood.”
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Krauss said that even the rare patients who (like Bari in the play) undergo a change that might strike some observers as positive — such as a surge in sexual desire — often experience the transformation as a problem.
“The sexual drive takes on almost a compulsive quality that most people do not experience as pleasurable,” he said. “It is almost unheard of to experience joy as a result of seizures affecting the brain.”
Nonetheless, both Crino and Krauss are intrigued by the philosophical issues that Laufer presents in “Be Here Now."
“The play might not be neurologically accurate,” Krauss said, “but it’s a very clever literary device.
“She poses a good question about whether treating a tumor is worth giving up joy. That’s an interesting quandary to contemplate.”
IF YOU GO
“Be Here Now” runs through Feb. 16 at Everyman Theatre, 315 W. Fayette St. Tickets cost $28.80 to $62. Call 410-752-2208 or visit everymantheatre.org.