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Sunday, August 7, 2016

The Brain That Couldn’t Remember

By 
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. 

Late last fall, I rode an elevator to the fifth floor of M.I.T.’s Brain and Cognitive Sciences Complex and walked down a long red hallway toward Suzanne Corkin’s office. I had known Corkin since I was a kid. Remember her friend, the surgeon’s daughter, the one she tin-can-­telephoned with as a little girl? That’s my mom. The surgeon who performed the experimental operation on Henry was my grandfather. When I was growing up, Corkin was a staple at my mom’s dinner parties. We had met many times before.Luke Dittrich 




This meeting was going to be different. I was in the final stages of writing a book about Henry, and Corkin was a central figure in it. Until then, however, she had been mostly inaccessible to me. If I ever hoped that my personal connection to Corkin would provide me any sort of privileged access, I had long since given up. When I first explored the possibility of writing about Henry, he was still alive, but I abandoned that effort after Corkin presented me with a confidentiality agreement stating that M.I.T. would allow me access to the “research project entitled ‘The Amnesic Patient H.M.’ ” only if the university had editorial control over anything I intended to publish. After Henry died and I decided to take another run at telling his story, Corkin turned down repeated interview requests, telling me that she was working on her own book about Henry and that her literary agent had advised her not to speak with me.

That time, I didn’t drop the project. Instead, I spent years shuttling between dusty archives and cutting-­edge laboratories, speaking with other researchers who had worked with Henry and other neurosurgeons who had worked with my grandfather. I followed Henry’s trail down all sorts of unexpected paths, and what I uncovered was alternately fascinating and disturbing, starting even before the day my grandfather drilled two holes in Henry’s head, levered up his frontal lobes and suctioned out some of the deepest and most mysterious structures in his brain. The questionable ethics that were the backdrop to Henry’s operation — a catastrophic blurring of the lines between medical research and medical practice — became clear early on, but my reporting also eventually raised serious questions about Henry’s treatment after he left the operating room, during the decades he spent as a human research subject, as well as in the eight years that have passed since his death.

Corkin welcomed me into her office and sat down across from me at a small round table. She was 78 and had retired from her full-time research and teaching duties. She had short reddish hair and red-­framed glasses. She had always been petite, but she looked unusually thin because she was battling a serious illness. She offered me a French chocolate from a glass bowl. I was grateful that she had finally agreed to an interview, though from the outset it was clear that this wasn’t going to be an easy one. Her answers were generally curt, offering the bare minimum of information in a clinical, dispassionate way, even when talking about major milestones in her past.

Shortly after we began, I asked whether she could describe the first time she met Henry, that initial encounter with the man who would go on to define her life’s work, and this is what she said: “No, but that’s not surprising. Because what you’re asking for is an episodic memory, and episodic memories typically don’t last that long, no matter what the situation is. Now, I’m sure there are exceptions, when, you know, say, somebody’s being raped, and she remembers every little detail of that event. But what probably happened in cases like that, that are very emotional, is that they were repeated many times after. They were rehearsed, mentally, and became semanticized. So no, I don’t remember what it was like to first shake hands with Henry, but if I did, it would probably be fiction rather than fact.”

Some of my most pressing questions had to do with a much more recent episode. Specifically, I wanted to ask Corkin about a secret custody war that had just been waged over Henry’s brain. It was a war very few people knew about, and it was a war she had won. It was also a war with serious implications, not just for the future of memory science but for its past.

When I brought up the subject, Corkin pursed her lips.
“I’m not going into this at all with you,” she said.

“Not at all?” I said. “Because I’d like to — ”
Corkin cut me off.
“You would, and so would everybody else.”



 Suzanne Corkin
Credit

The story of the war over Henry’s brain didn’t begin in a fancy conference room on Fifth Avenue in Manhattan, but that’s where one of its climactic battles would take place. It was March 2013, and there were more than a dozen participants, an impressive roster of scientists and administrators affiliated with four major institutions — M.I.T.; Mass General; the University of California, Davis; and the University of California, San Diego — as well as two major grant-­giving organizations, the Dana Foundation and the Simons Foundation. But the essential participants, the chief antagonists, were Suzanne Corkin and a man named Jacopo Annese.

Annese was a neuroanatomist. He was Italian, charismatic and handsome, and he drove a 1986 Porsche. Forty-­seven years old at the time, he had labored as a cook before he embarked on his present career. He liked using cooking analogies to explain the various elements of his work: For example, the craft of neurohistology — which can involve slide-­mounting and dyeing delicate slivers of neural tissue — was a lot like baking, he said, because in both endeavors the temperatures and times must be finely calibrated, precisely tuned, with little room for improvisation. He had lived in the United States for nearly two decades, climbing the rungs of an academic ladder that took him from the University of Rome to Dartmouth to the University of California, Los Angeles, to a position at the University of California, San Diego, where he founded his own laboratory, a place he called the Brain Observatory.


Jacopo Annese 
Credit

The Brain Observatory had the simple but ambitious goal of amassing the world’s most useful collection of brains. Its utility wasn’t ever going to be a function of its size — there were brain banks whose scale Annese couldn’t compete with — but rather would depend on its curation and its methods. Annese wanted to acquire exceptional brains, and he wanted to preserve them through an extraordinary process that he and his colleagues had developed. Corkin was impressed when she met Annese and later chose him to receive the object that would become the cornerstone of his collection. Not long after Corkin watched Henry’s brain being removed from Henry’s skull in 2008, she carried it in a small cooler to a JetBlue gate at Logan Airport in Boston, passed it to Annese and watched him walk down the ramp to the plane. Annese had bought two tickets, one for him and one for Henry.
Back in San Diego, Annese kicked off what he dubbed Project H.M. with what was possibly the most successful publicity stunt in the history of neuroscience. Near the first anniversary of Henry’s death, he live-­streamed the act that would enable all the work to follow: a 53-hour partitioning of Henry’s brain into 2,401 70-­micron-­thin slices. The stream registered 400,000 views, and it was catnip for science writers. During the silent feed, Annese placed little Post-it notes on the slicer, giving viewers a sense of the vibe in his lab. “Playing the White Album now,” one said.
After the spectacle died down, Annese and his labmates undertook the slow, glamourless, painstaking process of mounting the slices onto slides. They also began using the “block-face images” — high-­resolution pictures made during the slicing, when a camera mounted above the slicer snapped a shot just before each pass of the blade — to create a three-­dimensional model of Henry’s brain, one that could be whirled around and zoomed in and out of at will. Annese kept in touch with Corkin throughout these early stages of Project H.M., sending her updates addressed “Cara Sue” and receiving in return smiley emoticons.
Then, some months after the slicing, Corkin began asking for Henry’s brain back. At first, she and her colleagues asked for only parts of the brain and some of the data Annese had produced with it — the block-face images and tissue samples for a neuropathology exam. Annese was wary of handing over data before they had an agreement for how his work would be credited. He gave Corkin and her colleagues some of what they asked for, but not all of it. He hadn’t finished his work, and after investing so many resources, he expected more clarity. The longer Annese stalled, the more insistent Corkin’s demands became. Eventually, Annese prepared a paper based on his analysis of Henry’s brain and asked Corkin to contribute to it. But the dialogue between them was fraying. Shortly after Annese submitted the paper to the journal Nature Communications without Corkin’s participation, the summit was called in New York.
The parties gathered around the table, with Gerald Fischbach, then the director of life sciences at the Simons Foundation, assuming the meeting chair. After everyone introduced themselves and Annese presented his work on Henry’s brain, Fischbach asked Annese for his views on the brain’s custody. Two weeks earlier, M.I.T. sent U.C.S.D. a formal letter requesting that it turn over all 2,401 slices of Henry’s brain to a scientist M.I.T. had selected.
“I never felt like I owned the brain,” Annese said. He told the group that he didn’t really care where Henry’s brain ultimately resided, though he wanted to make sure that whatever happened, he and his labmates would receive fair credit and recognition for all the time and money and labor they had invested. It appeared that the question of where Henry’s brain would ultimately be housed — whether it would remain with Annese at U.C.S.D. or be moved at M.I.T.’s request — might be settled quickly.

“And how would you like to set this up,” Fischbach asked, “if it doesn’t really matter where the tissue is? Do you want to resolve that now? Or let the committee decide it?”
Corkin interjected. “It’s not a decision by the committee,” she said. “Because it’s a decision by the people who own the tissue. And that’s M.G.H. and M.I.T. And our decision is that we would like it to go to David’s lab.” By David, she meant David Amaral, who directed research at the MIND Institute at the University of California, Davis. M.I.T. and Mass General were proposing to transfer Henry’s brain to the MIND Institute, though not to relinquish ownership.


“In what sense do you own the tissue?” the chairman asked.
“We have a brain-­donation form,” Corkin said. She then passed a stack of photocopies of an old document around the table. The document appeared to show that Henry and his closest living next of kin had agreed, 16 years before Henry’s death, to donate Henry’s brain to M.I.T. and Mass General.
Although the donation form seemed to settle the matter of the brain’s ownership, the meeting became increasingly contentious. One item on the agenda was a discussion of the Nature Communications paper, which Corkin did not want to be published. Annese made what he hoped would be taken as a conciliatory gesture, telling Corkin that the journal’s editors had agreed to add her name as a co-­author.
Corkin said that adding “names to that paper isn’t going to make it publishable.” She continued: “It needs to be rewritten, as a serious scientific document.”


It’s not a serious scientific document?” Annese asked.
“It’s not sophisticated scientific writing,” Corkin said.

“That’s not what the other three reviewers said.”
The chairman intervened. “Somebody has read it and reviewed it,” he told Corkin.

One of Corkin’s colleagues jumped in: “Maybe the point is that [Annese’s paper] is not the definitive anatomical paper.”
‘I’m having an argument with myself,’ Henry would say over and over and over again.


“Of course it isn’t,” Corkin said. “Of course it isn’t.”
The chairman continued: “I’m uncomfortable criticizing a publication that one is not part of. If you [Annese] feel that, in your scientific judgment, it merits publication, and the reviewers have accepted it. ... It may not turn out to be the definitive paper. And that will be left, Sue, for you and your colleagues or for Jacopo to write.”

“There’s just melodrama,” Corkin said, referring to Annese’s paper.
“The reviewers found it sound scientifically,” Annese said. “Please, Sue, send me your comments.”
“You call him Henry,” Corkin said. “I mean, it’s so chatty! ‘During the surgery, Henry. …’ ”

“One reviewer talks about the data as stellar quality,” Annese said.
The quarrel continued until the meeting ended a half-hour later. In a follow-­up memo that was sent to all participants, representatives of the Dana Foundation summarized what they saw as the major decisions made. They wrote that Corkin would be added as a co-­author on Annese’s paper and that the “ultimate location” of Henry’s brain would be with David Amaral at the MIND Institute at U.C.-­Davis. But it would be up to Annese and Amaral to determine what tissue would be transferred and when.

Corkin quickly revised the memo, striking through the line outlining the timing and details of the transfer. Instead, she wrote, U.C.S.D. would simply “transfer all of H.M.’s brain tissue, including the tissue that has already been mounted,” to the scientist M.I.T. had chosen. At that point, M.I.T. and Mass General would write an agreement to “allow U.C.-­Davis certain rights to use and distribute the tissue owned by M.I.T. and M.G.H.” As far as Corkin was concerned, she and her colleagues owned Henry’s brain, period, and Annese had no say in the matter whatsoever.

Despite the unsettled question of where Henry’s brain would reside, the New York meeting did accomplish at least one thing. Now that Corkin had been added as an author on Annese’s Nature Communications paper, Corkin and Annese had to communicate to complete the revision process, breaking the chilly silence between them. What this new correspondence revealed was that despite what she said during the meeting, Corkin’s central problem with the paper, the one she pushed back on hardest, wasn’t Annese’s chatty writing style. Instead she was concerned with something Annese had discovered in Henry’s brain.

Specifically, Annese’s analysis had revealed a previously unreported lesion in Henry’s frontal lobe. The lesion was in the left hemisphere and appeared to have been caused by a man-made object. In his draft of the paper, Annese speculated that my grandfather had created the lesion when he levered up Henry’s frontal lobes to access the medial temporal lobes. This was a significant finding. As one of the paper’s anonymous peer reviewers pointed out, “much of the neuropsychological literature on H.M. has made the case that so-­called frontal function was intact.” In other words, for the previous six decades, neuropsychologists like Corkin had interpreted their experimental results with Henry under the working assumption that his lesions were restricted to the medial temporal lobes. The discovery of this new lesion might call some of their conclusions about the functions of the medial temporal lobes into question and require a re-­examination of all that old data.

When Corkin sent Annese her revisions of his paper, she deleted all references to the newly discovered frontal lesion. In a note to Annese, she explained that “the frontal lobe lesion does not appear on either the in situ scans [the M.R.I. scans made while the brain was still in Henry’s skull] or the fresh brain photos” and that “any consideration of it would be highly misleading.” She followed up with an email stating that her colleagues at M.I.T. and Mass General “believe that there is a good chance that the alleged orbitofrontal lesion is a handling lesion,” meaning that it was caused after death, during the extraction and subsequent handling of the brain. She added that “there is no intent by the [Mass General] group and me to hide evidence.”
‘In what sense do you own the tissue?’ the chairman asked. ‘We have a brain-donation form,’ Corkin told him.


Annese responded with a series of images from in situ M.R.I. scans that, contrary to Corkin’s assertions, gave clear views of the lesion, demonstrating that it could not have resulted from the post-mortem handling of the brain. Annese also sent imagery of some of the slides bearing that portion of Henry’s frontal lobes, and these slides seemed to support the idea that the lesion resulted from the use of a man-made object, like the “flat brain spatula” that my grandfather used during the operation. The lesion, Annese wrote to Corkin, “was previously unreported (we ascertained it was present even in the 1992–93 M.R.I. scans) and together with other data represents new evidence in the case.” He added: “I really don’t understand the reluctance. ... This is real flesh and blood. There’s a lesion outside the [medial temporal lobes], it is conspicuous and it should be reported. Remember, the goal of this paper and the archive is to catalyze new investigations as well as new debates, like the one we have been having.”

The arguments over the lesion and other aspects of the paper soon devolved into acrimony. A mediator hosted a conference call, and eventually a compromise was reached. The frontal lesion would stay in the paper, but it wouldn’t be featured as prominently as it was in earlier drafts.
Soon after, U.C.S.D. agreed to give up custody of the brain. If Annese was being honest with himself, he would admit that a part of him had considered holding on to the brain, or at least some pieces of it. His ego had given him a sense of entitlement. A sense of outrage, too. After the brain was handed over, he submitted his resignation to U.C.S.D. “I believe that, regretfully, this is the only way to provide a justifiable (and dignifying) narrative to the changes in course of the H.M. project,” he wrote.

Back in Corkin’s office, I pressed for her side of the story, her perspective on the fight over the brain.

“I don’t want to talk about it,” she said. “We have a brain-­donation form, right? That says it all.”

“I’m curious about, what was the paperwork — ”
She cut me off.
“I cannot talk about the paperwork,” she said.

The paperwork — the document she passed around the table at the meeting in New York — was only one page, and the crucial part took up just two sentences: “I, Thomas F. Mooney, am the court-­appointed guardian of the person of Henry G. Molaison. I also presently am Henry G. Molaison’s closest living next of kin, and as such I am entitled by law to control Henry G. Molaison’s remains upon his death.” The lines were followed by a signature and a date: Dec. 19, 1992. Corkin had arranged for Mooney to apply to become Henry’s conservator earlier that year. A probate-court judge, taking Mooney to be Henry’s closest relative, approved the conservatorship. One of Mooney’s first acts as conservator was to donate Henry’s brain to Corkin and her colleagues. He also consented, with Henry’s assent, to the continuation of the experiments Corkin wished to conduct on Henry while he remained alive. The problem was, Mooney wasn’t actually Henry’s next of kin.

I asked Corkin whether she could tell me how, precisely, Mooney was related to Henry. She could not. It took me a long time to answer the same question. I made numerous phone calls and even showed up on Mooney’s doorstep once. He always made excuses for not being able to meet me. In court documents, I saw Mooney described as both Henry’s cousin and Henry’s nephew, but I had built out Henry’s family tree for three generations and was unable to find any blood ties. Eventually, over the phone, Mooney told me that he and Henry were third cousins, very distant relations.

I asked Corkin whether she was aware that when Mooney became Henry’s conservator, one of Henry’s first cousins, Frank Molaison, was living nearby — his actual next of kin — and had not been consulted. I mentioned that his name should have made him particularly easy to find.

“I was not aware of his existence,” she said.
I asked whether she had ever done any genealogical research at all into the man she had studied for almost a half-­century.
“No,” she said.
“So,” I said, “you were not aware that Mr. Mooney was not his next of kin?”

“No,” she said.
I had tracked down and spoken with Henry’s closest living relatives, and some were surprised and disturbed to learn about the things Corkin and her colleagues did with their cousin while he was alive and about the fight over his brain that took place after his death.

I asked Corkin why she arranged for Mooney to apply to become Henry’s conservator in the first place. I knew that for more than a decade before Mooney was named Henry’s conservator, Henry himself had been the only one signing the consent forms for his experiments.

“I just wanted another level of security,” Corkin said. “Another person who was not amnesiac and who had Henry’s best interests at heart.”

I asked what she meant by “security.” Security from what?
“For Henry,” she said. “For M.I.T.”

And what were M.I.T.’s vulnerabilities?
“I don’t know,” she said. “I’d have to ask our lawyers that.”
‘I’m curious about the paperwork,’ I told her. She cut me off. ‘I cannot talk about the paperwork.’


After the slides and the remaining brain tissue were turned over, M.I.T. and U.C.S.D. officials continued to negotiate over a final point of contention: the high-­resolution block-face images that Annese and his colleagues made during the slicing. In the end, U.C.S.D. agreed to one final demand: The digital data, too, would go. As someone who spent years grappling with Henry’s story, I knew that this was not necessarily a bad thing. However you interpreted the conflict leading up to the removal of Henry’s brain from San Diego, once that transfer happened, it seemed reasonable to want everything consolidated: all the material, all the data. This would make it easier for scientists to continue their analysis, mining Henry’s brain for any last revelations it contained.

You could imagine a moment decades in the future, when some eager and brilliant young researcher might hold to the light one of the slides Annese made from Henry’s brain, appreciating it for the historic and gorgeous and mysterious object it would always remain, not giving a damn who owned or controlled it. You could imagine that researcher digging into additional parts of the archive, including the block-face imagery, the other slides, the remaining unprocessed tissue. Maybe, just maybe, she finds something, some anomaly that nobody has ever noticed, something that might spark a new idea — a new hint about how we work or a new challenge to our old assumptions. Ideally, of course, that hypothetical researcher would be able to explore not just the archive of Henry’s brain but the archive of all the data that was collected from Henry’s mind while he was still alive, the reams of experimental and observational information that scientists had extracted from him after he left my grandfather’s operating room. The whole idea behind preserving Henry’s brain, after all, was to be able to compare and correlate his neuroanatomical data with the unprecedented amount of clinical and behavioral data that already existed in his case.
Most of that other data was presumably in Suzanne Corkin’s possession. So toward the end of my interview with her, I asked what she intended to do with her Henry files, the raw data she spent her career gathering.

Me: Are you aiming to give his files to an archive?
Corkin: Not his files, but I’m giving his memorabilia to my department. And they will be on display on the third floor.

(By memorabilia, she meant his personal effects — his Bible, his glasses, his crucifix — all of which she owned. She had also claimed copyright to every known family photo of Henry and his parents.)

Me: Right. And what’s going to happen to the files themselves?
(She paused for several seconds.)
Corkin: Shredded.

Me: Shredded? Why would they be shredded?
Corkin: Nobody’s gonna look at them.
Me: Really? I can’t imagine shredding the files of the most important research subject in history. Why would you do that?

Corkin: Well, you can’t just take one test on one day and draw conclusions about it. That’s a very dangerous thing to do.
‘I can’t imagine shredding the files of the most important research subject in history. Why would you do that?’

 
Boxes at U.C.S.D. that would eventually hold 2,401 slices of Henry’s brain.


 Me: Yeah, but your files would be comprehensive. They would span decades.Corkin: Yeah, well, the tests are gone. The test data. The data sheets are gone. Because the stuff is published. Most of it is published. Or a lot of it is published. Me: But not all of it.Corkin: Well, the things that aren’t published are, you know, experiments that just didn’t ... [another long pause] go right. Didn’t. You know, there was a problem. He had a seizure or something like that.Me: But you know, even what’s published — as you know, if you look at the papers, in some sense each paper is just the tip of the iceberg of the work that was done, and the work that was done — all that data floating around underneath — it seems to me that so much of that would be valuable to preserve. That people really may want to go back and review — Corkin: There’s no place to preserve it.

Me: There’s no place to preserve it? Not at M.I.T.? How many files are we talking here? Are we talking about a storeroom like this, full of boxes of papers? Corkin: No, not that much.Me: Are they mostly at your home now?Corkin: Some of it was. No, not now. It isn’t. No. Me: It’s just in storage somewhere?Corkin: Most of it has gone, is in the trash, was shredded.Me: Most of it was already shredded? Just recently? Corkin: Yeah. When I moved.Me: When you moved you shredded it?

Corkin: Mm-hmm.Me: And what is left, most of it you’re planning to shred? Corkin: Probably.(Elements of her story seemed to be shifting and flexing in real time. Whatever the details, though — whatever Corkin had or hadn’t yet shredded — the whole idea of willfully shredding any of Henry’s data struck me as deeply troubling.)   Me: Not to sound too high-flown here, but I could see future generations being disappointed that the primary-­source documents for the work that was done on Patient H.M. had been destroyed. Corkin: Well, I mean, there are other famous amnesiac patients, and their data aren’t available to the public

Me: But why would — it seems to me, and I think it gets back to this: He’s somebody who has been so fundamentally important to our understanding of ourselves. And it seems to me that the data that was used to provide this understanding of ourselves is almost a common heritage. Corkin: Yeah, but it’s not peer-­reviewed, for one thing. That’s important. The stuff that’s published is good stuff. Peer-­reviewed. You can believe it. Things that, you know, experiments that might not have been good experiments, there might have been inadequate control groups. ... There are all sorts of things that can go wrong with experiments. Not every experiment is publishable. Me: But they can still be interpreted by other people.

... Maybe as we continue to understand how the brain works, and how memory works, some of this existing data of H.M.’s could be reilluminated by new theories, by new ideas, by new — it just seems a shame to destroy it. And it also seems — and this would be the darker interpretation of it — it locks in stone your own telling of H.M.’s story. Corkin: Well, it’s not just me. It’s me and over a hundred colleagues.Me: I know. But again, you’re the principal investigator for the last many decades. And that is the story, then: When you destroy the data, that becomes the inalterable and sort of inviolate story of Patient H.M. And if you do destroy it, I can imagine people saying, Well, there certainly could be a self-­serving motive there. Corkin: I don’t think scientists would say that.

Me: O.K.Corkin: I think people like you might say that. She was wrong about that. It wasn’t just people like me. Later I told a number of neuroscientists — including researchers from Stanford and U.C.L.A. — what Corkin had told me about her shredding of Henry’s files, and almost all were appalled by what one described as her “cavalier destruction of data.”
 


 
Henry Molaison, then 60, at M.I.T. in 1986.By Jenni Ogden

Even as a nonscientist, I couldn’t help noticing that some of the unpublished data I came across while reporting my book went against the grain of the established narrative of Patient H.M. For example, unpublished parts of a three-page psychological assessment of Henry provided evidence that even before the operation that transformed Henry Molaison into the amnesiac Patient H.M., his memory was already severely impaired. The causes and significance of Henry’s preoperative memory deficits can be debated, but their existence only underscores the importance of preserving the complete record of the most important research subject in the history of memory science. 

I wondered what other surprises might be found in a full accounting of Henry’s data, at least the data that hadn’t already made its way to Corkin’s shredder. You didn’t need to be a scientist to grasp what this destruction meant. My grandfather had cut a hole into Henry’s memory, and now one of the many people who profited from that act was cutting another irreparable hole, this one into our memory of Henry.Eventually Corkin and I said goodbye, exchanged handshakes, stiffly wished each other well. It would be the last time we saw each other. She died not long afterward. 


An illustration of an operation similar to the one performed on Henry Molaison in 1953.
Credit
Copper photoengraving printed by the Grenfell Press for The New York Times. 

On the way out of her office, I noticed a framed photograph of Henry’s brain hanging on a wall. The photo was professionally shot and was taken in Annese’s lab, after the various membranes that had cloaked it were removed, leaving it fully exposed. The photo showed the brain in profile, close up. It was pink, the pink of a ballerina’s slippers, though a complex network of dark purplish veins crisscrossed its surface. The brain was, in its own way, beautiful, even if you divorced it from context, even if you didn’t know to whom it belonged or what it had taught us. Even if you didn’t know anything about its story.


 There was something aquatic about it, like a creature you might encounter while diving too deep in a dark underwater cave. Staring at it, I remembered something Annese told me once. He was complaining about the current trend of depicting the brain, with its myriad neural networks, as though it were some sort of electric metropolis. You could hardly glance at a newsstand’s magazine rack, he pointed out, without seeing a CGI cover illustration of the brain looking like a coruscating fiber-­optic fantasia, as though we were all walking around with Times Square blazing in our heads. Annese didn’t like that all-­electric metaphor. He saw the brain as more organic than that. Earthier. Not like a light bulb; more like an oyster. That didn’t strike me as right either, though.It’s not a pneumatic pump, a telephone switchboard, a tape recorder or any of the other objects people have compared it to over the years.Maybe the human brain is an object beyond the reach of metaphor, for the simple reason that it is the only object capable of creating metaphors to describe itself. There really is nothing else like it. 

The human brain creates the human mind, and then the human mind tries to understand the human brain, however long it takes and whatever the cost. I took one more look at the picture on the wall and tried to commit the moment to memory.

This article is adapted from “Patient H.M.: A Story of Memory, Madness and Family Secrets” by Luke Dittrich, to be published by Random House on Aug. 9.

http://www.nytimes.com/2016/08/07/magazine/the-brain-that-couldnt-remember.html?hpw&rref=magazine&action=click&pgtype=Homepage&module=well-region&region=bottom-well&WT.nav=bottom-well&_r=0

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