I like hard problems. When people ask me if there’s a link between my climbing life and my life in neuroscience, I usually say no. But one thing they have in common is that neither is easy for me. I like things I have to work on.
Mental puzzles have played an important part in my recovery. I already mentioned how my rescuers used riddles to keep me focused after the accident. Puzzles were also a yardstick for my mental abilities as I recovered. Kristin brought stacks of word puzzles to my bedside. I spent hours working on a Wednesday New York Times crossword. It felt like a triumph to finish it. Over time, things have gotten easier, but the joy of overcoming a challenge hasn’t gotten greater.
Puzzles were also a motif in a multi-day psychotic episode I experienced while in hospital. It’s the most fascinating experience I hope to never have again. Psychosis is a mental state where you become disconnected from reality. Your mind generates delusions that are extremely compelling, and your ability to objectively evaluate them breaks down. You hear voices from people who don’t exist, and you use all your powers of reason to explain to yourself why nobody else can hear them.
I’ll try to describe both my perspective at the time, and what I later learned had happened.
I had been in the DC hospital for about 3 days when I noticed something. When I closed my eyes, kaleidoscopic visual patterns would instantly appear. These were mostly made up of the same shape repeated many times in different sizes. Triangles, spirals, fractals. Pyramids upon pyramids. The patterns were infinitely complex. They were shades of a single colour, green or brown, and they drifted rapidly across my visual field, like looking down at a landscape from a low-flying plane.
I had been having trouble sleeping. Besides the wound vac rupture of my first night, there was an issue with my ventilator that made it go into uncontrolled feedback if I didn’t breathe very carefully. I didn’t know this wasn’t normal, and the medical team had not yet realized that the problem was with the ventilator, not my breathing. It was making it impossible to sleep for more than a short period at a time. While I knew I wasn’t sleeping, I didn’t connect my lack of sleep to these visual patterns.
The trauma unit, Ward 4, treats people fighting for their lives. Burn victims, shooting victims. Patients were often flown in by helicopter, and the countdown to their arrival would play over speakers throughout the ward.
I heard a doctor in the hall say they had run out of room for a burn victim. There were students around. One cocky resident – let’s call him Z – shouted that they should get rid of me to make room for someone who really needed saving. Why were the nurses spending time taking care of me, a stable patient with a bit of pneumonia? Why were they playing favorites?
The trauma team put me on ‘sleep protocol’: no disruptions at night, lights out. Meghan brought me her noise-canceling headphones to block out the beeps and boops of the machines. The nurse was so kind to me. She washed my face and tucked me in with extra pillows and a warm blanket. I felt guilty that every moment she spent with me she could be helping someone who needed it more next door.
The night was strange. I closed my eyes and the kaleidoscope started again. It moved fast at first, 2D patterns panning quickly past my eyes. Over time, I relaxed, and the patterns slowed down and evolved. They sometimes morphed into text, drawn from bizarre categories: Indian foods. Terminal commands. Song lyrics.
As I relaxed more, my tongue started moving rapidly in my mouth, rubbing against the ventilator bit between my teeth. I could work to stop it, but as I relaxed again it would come back. I was fascinated by these phenomena, and was sure the doctors would want to hear all about them.
All this time, Z was trying to keep me awake. Banging on the walls, running back and forth by the door, chanting. I could just barely hear him despite the headphones. He was pestering the nurse, betting her that he could keep me from sleeping. I tried to ignore him. He’d go away for a while, then he’d come back. I wasn’t particularly bothered. I knew I should sleep, but it wouldn’t be the end of the world if I didn’t.
I’m not sure how much I slept that night, if at all. In the early morning, I asked the nurse about Z.
She, of course, had no idea what I was referring to. I tried to explain. She wrote a note in my chart as she left since it was already past the end of her shift. Over the course of that morning, my delusions became more elaborate.
I could hear more voices, but these were different people. They were moral allies of Z’s, who wanted to pay me back for taking space from others who needed it more. Let’s call them the hackers. They spoke to me by focusing sound in a small region around my head, so nobody else could hear them. They could see me through cameras in the hospital room. I switched to writing in pencil, so it would be harder to read over the video feed, but it didn’t work. They could use electromagnetic interference to hijack the machines keeping me alive. Every time the ventilator malfunctioned, it was them toying with me.
My care team were worried about me. I was writing notes, then asking them to flush them down the toilet. I tried to move the bed, to escape the hackers’ tightly focused bubble of control. When the doctors asked me what was wrong, I’d pretend everything was fine, because I didn’t want anyone to think I was crazy. I was scheduled for a general anaesthesia procedure that day, an ERCP. The perfect opportunity for the hackers to do away with me.
Agatha had found the Popular Mechanics Riddle of the Week, and thought she would distract me by reading me puzzles. Most of these were logic puzzles in the style of Raymond Smullyan’s books, which I had worked out before. So she skipped to #54, “the Hardest Logic Puzzle Ever”:
Sailing through a thick fog, you come upon a mysterious island shrouded in mist. A towering volcano in the center of the island pierces the clouds, billowing smoke into the sky. You land your boat and set out to ascend the peak. After an arduous climb, you approach the volcano summit, where lava glows red within a vast crater. Here, you are approached by three gods.
On the summit of this remote volcano, you realize a few things through divine intervention.
First, you know that one of the three gods always tells the truth, another always lies, and the third will respond to questions randomly. Therefore, let us call the gods True, False, and Random.
The gods speak a different language. They understand all languages perfectly well, but only answer questions with either ja or da, the words for yes and no. You do not know which god is which, and you do not know which word means yes and which word means no.
Finally, you have an existential problem on your hands. You may ask three yes-or-no questions, each one directed to only one god, and only that god will answer with either ja or da. If you can determine the identities of the three gods, they will send you on your way with their blessing, and you can be assured of a prosperous and fulfilled life. If you fail to determine the identities of the gods, however, they will be less generous in their treatment. The volcano pit smokes and glows red beside you.
With your three questions, how do you figure out which god is True, which is False, and which is Random?
The hackers were watching. They made me a deal. If I could solve the puzzle before the ERCP, they would let me live.