The Molecule of More

who congratulated me—what will they think when my name disappears from the list? 
No one stays on the list forever; how will I bear the humiliation of being dropped? 
No one likes to lose, but it’s ten times as bad after you win. When you 
open the magazine expecting to see your name and it’s not there, you 
get an unpleasant feeling in the pit of your stomach.
Winners cheat for the same reason that drug addicts take drugs. 
The rush feels great, and withdrawal feels terrible. Both know that their 

---

87
DOMINATION
behavior has the potential to destroy their lives, but the desire circuit 
doesn’t care. It only wants more. More drugs, more success. But true 
success doesn’t come from cheating. If you make a mistake, people will 
forgive you, but if you act dishonestly, it will stick with you for a long 
time. That’s why the control circuit is so important. It’s rational. It’s 
able to make cool, reasoned decisions, ones that will maximize your 
welfare not just today, but far into the future. And yet, for many people, 
fraud is a powerful, sometimes overwhelming temptation when chasing 
the high of victory. At least in the short term, fraud works.
Or you could just punch somebody.
HOT AND COLD VIOLENCE
Dr. Jones stood in the elevator, dreading the patient interview that was about 
to happen. It was 1:00 
am
, and she had been called down to the emergency 
room to evaluate a patient who said he was going to kill someone. She had 
to get it right. When a psychiatric patient follows through on a threat to 
commit murder, the victim dies, the killer must be caught—and the doctor 
who set the killer free can be held responsible.
The patient, disheveled and malodorous, stared unblinking at Dr. 
Jones. He had been here before. He had been disruptive and uncooperative. 
During one stay he was accused of inappropriately touching a woman being 
treated for schizophrenia. He claimed he was allergic to all psychiatric med-
ications except Xanax. 
Apart from cocaine use there wasn’t much wrong with him psychiatri-
cally, but tonight he demanded to be admitted to the hospital. He mentioned 
multiple arrests and a three-year stint in prison. If he wasn’t taken up to 
“the unit,” he said, he would carry out his plan and kill someone. 
“Let’s just say it’s someone who did something to me, okay?” he said.
Paranoia is one of the most treatable psychiatric conditions associ-
ated with people who threaten violence. Paranoia makes them feel afraid, 
and sometimes they conclude that the only way to protect themselves is to 
kill the people they imagine are plotting against them. With antipsychotic 

---

88
THE MOLECULE OF MORE
medications, the delusions, along with the risk of violence, usually go away 
in about a week. 
But the patient who sat across from Dr. Jones, with his eyes still drill-
ing into hers, wasn’t psychotic.
Dr. Jones faced a dilemma. She knew that the patient wouldn’t ben-
efit from an inpatient stay, and admitting him to the unit would put other 
patients at risk. On the other hand, he had a history of violence. She admit-
ted him, fearing for the safety of the victim he refused to name, but feeling 
guilty for potentially endangering the patients on the ward. 
Violence is sometimes the result of dysfunction or pathology. But most 
of the time, violence is a choice—a coercive and calculated way to get the