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Sunday, August 7, 2016
The Brain That Couldn’t Remember
By LUKE DITTRICH Aug. 3, 2016
The untold story of the fight over the legacy of “H.M.” —
the patient who revolutionized the science of memory.
Can
you tell me who the president of the United States is at the moment?”
A
man and a woman sat in an office in the Clinical Research Center at the
Massachusetts Institute of Technology. It was 1986, and the man, Henry
Molaison, was about to turn 60. He was wearing sweatpants and a checkered shirt
and had thick glasses and thick hair. He pondered the question for a moment.
“No,”
he said. “I can’t.”
The
woman, Jenni Ogden, was a visiting postdoctoral research fellow from the
University of Auckland, in New Zealand. One of the greatest thrills of her time
at M.I.T. was the chance to have sit-down sessions with Henry. In her field —
neuropsychology — he was a legendary figure, something between a rock star and
a saint.
“Who’s
the last president you remember?”
“I
don’t. ... ” He paused for a second, mulling over the question. He had a soft,
tentative voice, a warm New England accent.
“Ike,”
he said finally.
Dwight
D. Eisenhower’s inauguration took place in 1953. Our world had spun around the
sun more than 30 times since, though Henry’s world had stayed still, frozen in
orbit. This is because 1953 was the year he received an experimental operation,
one that destroyed most of several deep-seated structures in his brain,
including his hippocampus, his amygdala and his entorhinal cortex. The
operation, performed on both sides of his brain and intended to treat Henry’s
epilepsy, rendered him profoundly amnesiac, unable to hold on to the present
moment for more than 30 seconds or so. That outcome, devastating to Henry, was
a boon to science: By 1986, Patient H.M. — as he was called in countless
journal articles and textbooks — had become arguably the most important human
research subject of all time, revolutionizing our understanding of how memory
works.
Of
course, Henry didn’t know that. No matter how many times the scientists told
him he was famous, he’d always forget. (It was an odd sort of fame: The
scientists kept even his first name a closely guarded secret from the outside
world and didn’t reveal it until after his death, when it was unveiled in a
front-page obituary in this newspaper.) Similarly, Henry didn’t know why he was
in a wheelchair that day, in the office at M.I.T., because he didn’t remember
badly spraining his ankle a few weeks before.
He
had big ears, big hands and, often, a big smile. Earlier, Ogden asked if he
could place her accent, and he guessed that she was British, then Canadian,
then Swedish. She gave him a short list to choose from, and eventually he made
his way to New Zealand. She then asked if he could tell her anything about New
Zealand. He impressed her by noting, correctly, that it was a country of two
islands. In his spare time, Henry liked doing crossword puzzles, and his
knowledge of geography was decent. This was one of the things about Henry that
fascinated scientists: His amnesia often appeared, as they termed it, pure.
There was an abyss in his brain that all the passing events of his life tumbled
into, but on the surface he could seem almost normal.
“Now,”
Ogden continued, “if I tell you that the president now used to be a film star,
does that help? Not a very good film star, but he used to be one a long time
ago. I think he used to be a film star in westerns. And he’s the president of
the United States. Rea ... ?”
The
syllable tripped a circuit in Henry.
“Reagan,”
he said.
“Reagan!
Very good. Do you remember he used to be a film star?”
“Well,
yes.”
They
spoke for a while about other film stars he remembered. Gary Cooper. Myrna Loy.
Jimmy Stewart.
“What
about Frank Sinatra?” Ogden asked Henry.
He
considered the question.
“Well,”
he said, “he did a lot of singing, and he was in films and on the stage and
radio and records.”
“Do
you think he’s still alive, Frank Sinatra?”
Henry
paused.
“There
I don’t know.”
The
scientists posed these sorts of questions to him, questions about who was
living and who was not, relentlessly. They wanted to see if even the most
drastic events — and nothing in life is more drastic than death — had failed to
stick. At one point, Henry responded to some other questions of Ogden’s by
telling her that he thought he lived at home with his mother in East Hartford,
but he wasn’t sure about his father, because he had a feeling that maybe his
father had died. In fact, Henry lived in a nursing home when he wasn’t living
on-site at the M.I.T. Clinical Research Center, and both his parents were long
deceased. Henry would learn of someone’s death and grieve in his own quiet way,
but if he wasn’t constantly reminded of his loss, that person would soon slowly
come back to life in his mind. This cycle of death and resurrection may have
been painful. For a while, Henry made a habit of carrying around a little scrap
of paper reminding him that his father was dead.
Now
Ogden asked about someone who was still living, someone who was neither a
celebrity nor a relative, but someone who loomed large to Henry.
“Who
or what,” she asked, “is Sue Corkin?”
“Well.
She was a ... like a senator.”
“A
senator?”
“Yeah.”
The
relationship between Suzanne Corkin and Henry Molaison was one
of those that appear, when traced to their roots, to be almost fated. Corkin
was born in Hartford Hospital, the same hospital where Henry received his
operation. She grew up across the street from the neurosurgeon who operated on
him and was close friends with the surgeon’s daughter. The two girls would
gossip deep into the night on tin-can telephones strung between their bedroom
windows. They ended up going off to Smith College together. Corkin majored in
psychology and, upon graduation, went to Montreal to pursue a master’s and a
Ph.D. at McGill University. There, her adviser turned out to be a woman named
Brenda Milner, a brilliant neuropsychologist who in 1957 had written — with
Corkin’s old neighbor, the neurosurgeon — the first groundbreaking paper about
Patient H.M. After Milner moved on to other interests, Corkin moved in, and by
the 1970s had inherited her mentor’s most important research subject, becoming
the lead researcher in his case. Corkin built much of her subsequent career on
the back of her privileged access to Henry and became both his gatekeeper —
fielding requests from other scientists who wished to meet him — and his chief
inquisitor.
Fated
or not, Henry and Corkin’s relationship was unusual, in that it was almost
entirely one-sided. Corkin knew Henry intimately, spending decades gathering
the most minute details of his strengths and his deficits. But Henry, squinting
through the haze of his amnesia, didn’t know the first thing about Suzanne
Corkin. Each of the hundreds of times they met, it was, for Henry, a first
meeting, though over the years little shards of feelings and associations
seemed to have accrued. Maybe it’s understandable that Corkin’s name would
eventually spark the image of a senator in Henry’s mind, because she became
such a dominant authority figure in his life.
Henry Molaison in 1958.
The history of brain science is rich in these sorts of
one-sided relationships. A great deal of what we know about how our brains
work has come about through intensively scrutinizing individuals whose brains
don’t work. An accident jettisons an iron rod through the left frontal lobe of
a mild-mannered railroad foreman named Phineas Gage, transforming him into a
full-bore hellion, thus allowing researchers to begin deducing the functions of
those oversized saddlebags behind our forehead and eyes. A man with a lesion to
the left superior temporal gyrus is unable to understand what’s said to him,
spurring the neurologist Carl Wernicke to conclude that this area must be
essential to language comprehension. Another man, with a lesion to the left
inferior frontal gyrus, is able to understand speech but can’t articulate any
words himself, other than a single syllable — tan, tan — providing a
French surgeon named Paul Broca a glimpse of the cerebral root of language
production.
In that pantheon of illuminatingly broken men and women, Henry
stands apart. It is difficult to exaggerate the impact he has had on our
understanding of ourselves. Before Brenda Milner collaborated on that first
paper about Henry, the prevailing theory of memory held that its functions
could not be localized to a single cortical area, that learning was distributed
across the brain as a whole. By that theory — built upon the experimental
lesioning of the brains of rats — a person’s memory would be affected only in
proportion to the amount of brain tissue removed, regardless of which brain
structures the tissue was removed from. Milner’s first paper about Henry, along
with her previous work, upended this view. She demonstrated, with elegance and
rigor, that Henry’s amnesia was profound — possibly the most catastrophic she
had ever seen — and declared that it must have been a result only of the
relatively small and specific bilateral lesions to his hippocampus and other
medial temporal structures left by the operation. This was an astonishing
revelation. It was not the last.
Five years after Milner’s first paper about Henry, she published
a second that was almost as revelatory. That paper documented Henry’s gradual
improvement over a three-day period on a difficult hand-eye coordination task.
His improvement came despite his inability to ever remember his previous
attempts at the task, indicating that there are at least two different memory
systems in the brain — one responsible for our conscious, episodic memories,
the second responsible for task-or-skill related “procedural” memories — and
that these two systems seem to rely on entirely distinct parts of the brain.
This was another fundamental step forward in our understanding of how memory
works. Together, Milner’s two Henry-related revelations can be viewed as the
cornerstones of modern memory science.
After Corkin took over the research, the revelations kept
coming, though now they were of a smaller scale. Corkin and her colleagues
added fine detail to the portrait of Henry’s damaged condition, filling in gaps,
but the weight of their work could seem slight when compared with Milner’s
monumental achievements. Corkin and her colleagues learned that if you placed a
pain-inflicting device called a dolorimeter to Henry’s chest, he wouldn’t
complain even as his skin began to turn red and burn. She learned that if you
presented him with two dinners in a row, he would eat them both, because by the
time he began the second he would have forgotten the first. She learned that he
was apparently asexual and that there was no evidence of his ever even
masturbating. She learned the ins and outs of his temperament, the frequency of
his tantrums, the patterns of his infrequent complaints. She noted the odd
exceptions to his amnesia, like the fact that Henry, after years of watching
the sitcom “All in the Family,” eventually came to know that Archie Bunker’s
son-in-law was called Meathead. Corkin cataloged his verbal tics, his
malapropisms, his stock phrases.
“I’m having an argument with myself,” Henry would say, over and
over and over again.
As the experiments piled up and the data accumulated, Henry
became a boon not just to science but also to Corkin’s career. She started her
own lab at M.I.T., and although she and her colleagues conducted research in a
number of areas, the papers that generated the most attention were always the
ones about Henry. When they first met, Corkin was a young graduate student in
her 20s. She grew older. She became a renowned professor of neuroscience at one
of the world’s greatest universities. Henry grew older, too, though he wasn’t
exactly aware of it. In Henry’s later years, people were always asking him how
old he thought he was, and he would make a series of guesses. Was he in his
30s, his 40s, his 50s? He had only the vaguest sense of the passage of time.
Then someone might pass him a mirror and watch him gaze into his own elderly
eyes.
“I’m not a boy,” he would say, finally.
Henry died on a winter afternoon in 2008. The next morning,
Corkin peered through a window into an autopsy room at Massachusetts General
Hospital, watching as two men cut off the top of Henry’s skull. For 46 years,
Corkin had been having her one-sided meetings with Henry, endlessly
introducing herself to an old friend. Now she was having one last encounter
that only she would remember. The men carefully pulled out Henry’s brain, and
Corkin gazed at it through the glass, marveling at this object she had spent
her career considering at one step removed.
Later, reflecting on that moment, Corkin could think of only one
word to describe her feelings. She was, she wrote, “ecstatic.”
It would be reasonable to assume that the strange relationship
between Suzanne Corkin and Henry Molaison ended that day, but that assumption
would be wrong. As it turned out, some of the most astonishing, and troubling,
episodes in the long saga of Suzanne Corkin and Henry Molaison were still to
come.
Dr. William Beecher Scoville (right), who conducted an experimental operation on Henry’s brain, in an undated photograph.
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