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By Dr Tom Christie

January 29th, 2014

DEMENTIA’S FINAL FRONTIER: Portrayals of Dementia in Star Trek

Science fiction has a good track record of dealing with hard-hitting issues, often by allegorical or indirect means, and none more so than the stalwart Star Trek television franchise.  The voyages of the Starship Enterprise have, since the 1960s, provided the basis for an exploration of topics ranging from international foreign affairs to social justice.  Often neglected, however, is the series’ capacity to explore more personal matters such as those deriving from mental health, and to face up to the implications that psychiatric conditions can present for the individual.

Star Trek’s infrequent brushes with the issue of dementia started back in 1967 with ‘The Deadly Years’, an episode from the second season of the original TV series.  During a mission to supply essential materials to a distant human colony on planet Gamma Hydra IV, Captain Kirk and his shipmates are affected by peculiar radiation from the trail of a transitory comet which causes them to age by approximately thirty years for every day that passes.  As well as undergoing rapid physical deterioration, the mental wellbeing of the crew is also compromised.  Kirk, the archetypal quick-thinking man of action, becomes confused and indecisive.  Mr Spock, the half-Vulcan science officer famed for his towering intellect, discovers that he is having memory problems and suffering from severe lethargy.

As Kirk emphasises, his function as a commander is impaired not so much by the fact that his bodily frailties have rendered his usual fast reflexes and swashbuckling capabilities impossible, but rather by the toll that the radiation has had on the acuity of his thought processes.  Given to uncharacteristic outbursts and violent mood swings, his executive functions soon erode to the point that - much to his chagrin - a less experienced officer eventually supplants his command of the ship.

Dementia presents a kind of professional nightmare for a character like James T. Kirk.  It first robs him of his trademark cunning and decisiveness, then leads him into the depths of disorientation, and finally cripples his hitherto-unshakeable sense of authority by allowing him to be undermined and eventually usurped by a largely-untested rival (a consequence which almost leads to the destruction of the ship).  Even the episode’s resolution, where some out-of-the-box thinking by Spock and the ship’s chief surgeon Dr McCoy restores the afflicted crewmembers to their normal health (and age), helps to underscore the point that it is Kirk’s intellectual vitality rather than his physical fitness which is most essential to the smooth operation of the ship.

Dementia proved to be an antagonist that Kirk and his crewmates only barely manage to defeat; unlike more recognisable Star Trek villains such as the Klingons, it cannot be reasoned with or outmanoeuvred.  This theme of progressive psychiatric deterioration as an adversary to be fought against would resurface many years later in 1994 with ‘All Good Things...’, the final episode of Star Trek: The Next Generation.  Here, Kirk’s successor Captain Jean-Luc Picard finds himself in a future reality where he is in the later stages of the fictional ‘Irumodic Syndrome’, a form of dementia which exhibited various symptoms including hallucinations, memory loss and mood swings.

Even more so than Kirk, Picard is a cerebral figure, far more inclined to puzzle out a winning strategy than to shoot first and ask questions later.  His incapability to discern reality from delusion, therefore, proves devastating to someone whose command ability is so closely wedded to his impressive powers of observation and deduction.  Through the lens of his Cartesian struggle to distinguish between the real and the unreal, the possible and the probable, the viewer determines a vague taste of the frustration which characterises the corrosive effect that dementia can have on even the most fundamental aspects of perception.

The Star Trek franchise’s other explorations of dementia have generally tended to focus on this central aspect of identifying the difficulties inherent in distinguishing an authentic reality from an illusory environment.  The Next Generation episode ‘Frame of Mind’ sees the Enterprise’s first officer William Riker mentally programmed to believe that he is affected by vascular dementia, plunging him into deep anxiety as he is faced by numerous overlapping variations of reality (or, more precisely, what he perceives to be reality) which contradict and contend with each other.  Later spin-off series Voyager was similarly to riff on this theme, with episodes such as ‘The Fight’ obliquely dealing with the damage to cognition which derives from dementia pugilistica, while ‘Projections’ instead explored a computer-based dementia - ‘holo-transference dementia syndrome’ - which leads an artificial intelligence with the physical form of a human to believe that he is real and that the world around him is an illusion.

Pursuing the basic notion of what reality actually is, and how it may be recognised or quantified, is certainly not a new line of enquiry for a television franchise such as Star Trek.  Depictions of dementia, however, are markedly less common, and although the series initially seemed almost timid about discussing the condition explicitly, it should be commended for treating the issue in a serious and non-sensationalist manner.  In exploring the disorder by examining its effects on regular characters in the series, with whom viewers have had the opportunity to establish emotional investment (sometimes over several years), television drama has a unique ability to present sensitive issues such as mental health in an innovative and uncompromising way, and the Star Trek universe - with its overriding themes of inclusiveness and social justice - provides the perfect foundation upon which to construct a meaningful engagement with a subject which has deep personal relevance for an increasing number of people.