The Procedure and Brain Chip From 'Severance' Might Not Be Far From Reality

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The Apple TV Plus series Severance just aired its explosive second season finale, and it blew my mind -- no pun intended. This season was filled with answers to some riddles, and more questions about what the cult-like company Lumon is doing. We were treated to gorgeous shots of wintry landscapes reminiscent of Ragnarok, a bleak and artificial goat farm and an animatronic wax sculpture that can't take a joke.

Beneath the fantastical visuals and dry humor, at its core, Severance is about identity. It asks whether we are better or worse for removing certain parts of our own consciousness, and it explores that idea through a brain-splitting procedure and chip.

And while a consciousness-dividing chip sounds like the type of science fiction that borders on fantasy, the science in the show is rooted in reality.

I spoke with Dr. Vijay Agarwal, the medical consultant for the show, and the chief of the skull base and minimally invasive neurosurgery division at Montefiore Medical Center. He said the showrunners wanted to make the series as true to science as possible.

"I came in and met the team and I met Ben [Stiller] and they told me what their vision was," he said. "They really wanted to make sure that it was very, very accurate."

That accuracy extends from how a seizure is portrayed on screen to the terrifying truth that the brain chip responsible for the absurdity and horror of the series might become a reality within our lifetime. And it raises ethical and moral questions about whether or not we should pursue this technology.

*Spoilers ahead for Severance season 2.

The science of Severance

The severance chip in the show is the central plot device in the series, and it splits a person's consciousness into at least two parts -- the titular severance. A surgery is performed to implant the chip into someone's brain near the amygdala and the hippocampus.

"Those are the actual structures that can really affect our ability to associate and adjust memory and emotion," Agarwal told me.

Since the chip is implanted near the amygdala and hippocampus, this causes a person to have different memories and emotions when the chip is activated. The result is two separate consciousnesses. In the show, one is called an "outie," the part of a person's consciousness that exists outside of work. The other is called an "innie," and all they know is what's inside of their job.

The result of the severance procedure and chip is people get to shut their brains down for a large chunk of the day. When the chip is activated, it flips a switch in the brain and the outie can avoid the monotony of their mysterious and important work in the sterile office setting. That also means for Adam Scott's character Mark, for example, he can escape the grief of losing his wife Gemma.

Importantly, the consciousness separation in the show is distinct from dissociative identity disorder, or what was previously known as "split personalities."

"When people have dissociative identity disorder, oftentimes you can get completely different sorts of personalities," Agarwal said.

A woman with the outline of her brain showing through her skull.

The 1886 novel The Strange Case of Dr. Jekyll and Mr. Hyde can be interpreted as a representation of someone who suffers from dissociative identity disorder. In that book, Jekyll is amiable and generally well-liked by others, but when he takes a serum, he transforms into the cruel and remorseless Hyde.

Severance viewers might think a person's innie and outie are two distinct people like Jekyll and Hyde, but the show explains that the procedure and chip split a person's "perceptual chronologies." So the innie is only aware of their own experiences and the passage of time while they are conscious, and vice versa. It would be like if you blinked and eight hours had passed and for some reason you had a chipped tooth. You don't know what happened in that time to give you that chipped tooth, but your innie does.

That doesn't mean the innies and outies are different people, just that they have different experiences to help shape their outlook. And these versions of the same person can still share personality traits.

"John Turturro's character Irving is a perfect example," Agarwal said. "He's got a bit of a quirky personality, kind of a dark aura about him, but that carried over to his Outie, as well."

Unlike Jekyll's serum, the prospect of a consciousness-splitting chip isn't that far away from the technology we have today.

Agarwal told me that some companies like Neuralink and Synchron are working on figuring out ways to deliver electrical stimulation to the brain to help bring back mobility to people who are paralyzed or who have limited mobility, or to help them complete digital actions. He said to think of the brain like a circuit board or a computer.

"If you're able to adjust the way that electricity goes into a circuit board or computer you could affect the way that your computer works," he said. "There's a lot of other companies that are basically looking at ways to deliver electrical stimulation to the brain to make neurons fire a certain way."

Doctors are already using electrical stimulation in the brain as part of some treatments, as well. This type of treatment is called deep brain stimulation. With this treatment, an electrode is surgically implanted into the brain, and it could help people with profound obsessive compulsion disorder, depression, addiction, and some neurological disorders.

"It's already a well-accepted treatment for people who have Parkinson's disease," Agarwal said.

According to Johns Hopkins, when deep brain stimulation is used to treat Parkinson's, it interrupts the irregular electrical signals firing in the brain that cause tremors. Thus, this treatment can give someone with Parkinson's more control over their body.

Of course, using brain implants to treat conditions and disorders like Parkinson's isn't the same as using the severance chip in the show to escape reality. And like any major medical procedure, there are risks associated with the surgery on the show.

The numbers -- and the brain chip -- are scary

All medical procedures can be dangerous to a degree, especially when dealing with a sensitive organ like the brain. And a mistake in a brain procedure like the one in the show could be catastrophic.

Agarwal said the brain doesn't like to be manipulated or touched, so one of the physical risks includes bleeding of the brain, a type of stroke, which could be deadly. And because the severance procedure and chip would alter the electrical signals in someone's brain, it could cause a seizure.

"Any time you affect the abilities of the brain to function, or change the function of the brain, it can function in a way that is unintended and a seizure would be one of those [ways]," Agarwal said.

Indeed, we see Mark have a seizure in season 2 when he tries to shut the brain chip down with the help of a character named Asal Reghabi. While Reghabi helped implant the chip and should have knowledge of how it works, there are still ethical concerns about what happens if a brain chip is unintentionally damaged and causes a seizure like this.

Dr. Anna Wexler is an assistant professor of medical ethics and health policy at the University of Pennsylvania, and she told me that the procedure in the show is concerning for a few reasons, especially because the procedure and implant don't seem to be well-known in the medical field outside of Lumon.

"You'd want to make sure that there are other people who know about the impacts of the procedure, other people who can help out if needed if something goes wrong with your implant," Wexler said.

After it's implanted, the chip could also potentially limit what healthcare you receive. Some implants, like cochlear implants and pacemakers for example, aren't compatible with MRI machines and before you get an MRI you need to tell your medical professional about these implants. But if medical professionals outside of Lumon aren't aware of the severance chip, severed people might suffer adverse -- or even deadly -- consequences from other medical procedures, like getting an MRI.

"So there's probably a way in which having the severed procedure affects their medical care," Wexler said.

A business complex that looks like a brain.

The chip in the show could also have some existential consequences. Namely, it's unclear whether the chip could help you escape a traumatic experience, which is the whole reason Mark undergoes the procedure in the first place.

Agarwal said the amygdala and hippocampus are related, so if we shut off access to a traumatic memory in the hippocampus we might also shut off any emotions in the amygdala that are associated with that memory. In Mark's case, he's shutting off the memory and emotions of his wife's -- apparent -- death, and in the show it seems to work.

But we don't know whether this would happen in real life. These are still two different areas of the brain, so Agarwal says shutting off a memory in the hippocampus might not affect the emotions associated with that memory stored in the amygdala.

"So maybe you don't know why you have this trauma or this PTSD or these really just very strong emotions. Maybe you don't know why, but you [still] have them," Agarwal said.

There's also the concern about who controls the chip and causes a person to switch from an outie to an innie. According to the Mayo Clinic, some people who have deep brain stimulation implants can turn them on and off with a remote control depending on the severity of the person's condition. The person with the condition remains in control.

That's not how things work in Severance.

In the show, we hear a ding and see a severed person's consciousness shift when they ride the Lumon elevator to and from the severed floor and when a severed person enters and exits certain cabins -- called birthing cabins in the show. There is also a way for Lumon to extend control of the chip beyond these areas via the show's Overtime Contingency Protocol like we see in the season 1 finale. So remote control over the brain chip and how it affects the severed employees rests with the company. The company could decide to activate the chip at will without the severed person's consent.

Are you your outie or your innie?

The severance procedure and chip might be fictional, but they show that technology doesn't exist in a vacuum. Advances in technology like those shown in Severance raise legal, moral and philosophical considerations, especially when that technology intersects with the human body and mind.

In season 1, Britt Lower's character Helly tries to quit her job on the severed floor multiple ways -- including by ending her own life -- only for her outie to send her a video response.

"Eventually, we all have to accept reality," Helly's outie, Helena Eagan, says. "I am a person. You are not. I make the decisions. You do not."

We see Mark grapple with this question in the season 2 finale, as well. He asks his innie to essentially sacrifice himself to save Mark's wife Gemma from the bowels of Lumon, but his innie wants to live and be happy with someone he loves just like his outie does.

Mark and Helly in an old covered up office space.

Technically, outie Mark signed consent forms allowing innie Mark to be created, so does that give outie Mark the right to determine what innie Mark can and can't do? Can outie Mark therefore have innie Mark retired or erased? Are innies and outies really different people or are they just different sides of the same person?

In any case, it raises the question of why either version should have authority over the other. Why should outie Mark's decisions override innie Mark's? Is there a way to allow innies and outies to coexist in one body?

Perhaps the most terrifying question is: Will we ever see this tech in our world?

These questions might not be hypothetical

Brain chips that block out memories aren't impossible, but we could get technology that actually strengthens our memories first.

Wexler told me about a company called Nia Therapeutics that is working on a way to restore and strengthen memories using implanted brain computer interfaces. The company says it's working to create a pacemaker-like device for the brain that can potentially help treat memory loss in people with traumatic brain injuries.

Notably, what Nia Therapeutics is proposing is almost the exact opposite of what the procedure and chip in Severance do. The company's procedure could help strengthen people's memories, as opposed to taking memories away.

But if we can find a way to improve memories, it's possible we could also figure out how to block traumatic memories out altogether.

"It's not that big of a jump to say maybe in the future, we could maybe separate traumatic or painful memories from our daily lives," Agarwal said. "We went from being able to fly [in 1903] to the first passenger flight in 11 short years in 1914."

If the technology does become a reality, try not to forget the wise words of the show's Dr. Rickon Lazlo Hale, "Our job is to taste free air. Your so-called boss may own the clock that taunts you from the wall, but, my friends, the hour is yours."

For more on science, here's how interdimensional travel, like in Apple TV's Dark Matter, could work and why we probably can't stop a tornado like in the movie Twisters.

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