Will Byrnes's review of Patient H.M. (original) (raw)

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Will Byrnes's Reviews > Patient H.M.: A Story of Memory, Madness, and Family Secrets

Patient H.M. by Luke Dittrich

Patient H.M.: A Story of Memory, Madness, and Family Secrets
by

1526851

On December 5, 2008, the front page of the New York Times included an unusual item: H. M., Whose Loss of Memory Made Him Unforgettable, Dies. It was hardly the first time that an obit piece had appeared on the front page, but it is unlikely that many with quite so little public recognition had ever appeared there. The “H.M.” in question was one Henry Gustave Molaison. He has been the inspiration for many books, at least one play and a major motion picture. Mostly, though, while he had never studied medicine, or practiced in any medical field, Molaison had made a huge contribution to our understanding of the human brain.

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Luke Dittrich -From PRHSpeakers.com

Young Henry was seriously concussed in a biking accident when he was a kid. As a teenager he began having grand mal seizures. His symptoms increased and seriously affected his ability to function in the world. Drug treatments had proved unsuccessful. It was a new thing for such a procedure to be done for someone who was not considered mentally ill, but in 1953, when he was 27 years old, Henry was given a lobotomy. From that day on, he would no longer be able to form new memories. He would also be unable to fend for himself. But he was perfectly lucid, and able to have a life, albeit a restricted one. Because of his unusual condition, Henry became the primary neurological test subject of his time. He was examined, interviewed, and studied by untold numbers of researchers until his death. He was the subject of countless professional papers, in which he was always referred to in professional literature by his initials, in order to protect his privacy. Anyone working in the field would know well the initials HM. William Beecher Scoville was the doctor who had performed the risky surgery. He was Luke Dittrich’s grandfather.

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Dr William Beecher - from Dittrich’s Esquire article

Patient H.M. is both a medical and personal history, as Dittrich looks at the scientific advances that took place over a 60 year period, the history of his grandfather, and the life of Henry. It is perfectly accessible for the average reader, with a minimum of technical jargon. You will definitely learn some things, like the difference between episodic and semantic memory.

Memory scientists often speak of the important difference between knowing that a certain fact is true and knowing how you came to learn it. For example, here’s a simple question: What’s the capital of France? The answer probably leapt to your mind in an instant. Now, here’s another question: When did you learn that Paris is the capital of France? If you’re like most people, you have no idea. That particular fact twinkles in your mind amid an enormous constellation of other facts, most of them forever disconnected from the moment they first sprang to life. The store of mostly disconnected facts is known as your semantic memory.

Your semantic memory is contrasted with your episodic memory, which is your memory of fleshed-out narratives rather than merely facts. When you engage your episodic memory, you engage in a form of mental time travel, bringing yourself back to a particular place and time, reimagining a scene you’ve already lived. When you engage your semantic memory you are doing the mental equivalent of flipping through an encyclopedia or photo album, plucking out bits of information whose origins might be unclear.

This gives you a taste of how fluidly Dittrich writes of a subject that, in lesser hands, could easily have become dense.

Gramps was not exactly mister nice guy. He had a reputation for fast living and was very successful and ambitious, maybe to the point of excessive risk-taking. The state of mental health understanding and care in the 1950s is fascinating, and the stuff of nightmares. Nurse Ratched would have been right at home. Part of this tale is the fumbling from step to step that took place in trying to understand how the brain works. It makes one very thankful that we have technology today that can look at the brain with non-invasive machines instead of scalpels. It was news, for instance, that there were at least two kinds of memory, as noted above, and that they might reside in different parts of the brain. We learn how Henry came to be afflicted in his special way, how he lived, and how he was treated, both as a human being and a test subject.

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Henry as a young man - from The Telegraph

There are significant human rights issues here. Henry was and remained a human being, yet he was regarded by some researchers in a very proprietary way, in one instance being referred to in a legal document as “An MIT research project entitled “The Amnesic Patient H.M.” Not exactly warm and fuzzy. Academic turf-guarding comes in for a look. One researcher, in particular, goes so far as to destroy original data that might have jeopardized her career-long published findings. Access to Henry was guarded as energetically as the formula for real Coke, and not always for the purpose of looking after Henry’s best interests. Dittrich raises ethical issues, noting similarities between what was considered respectable medicine in the 20th century and barbaric behavior of the then recent past in how people had been used as test subjects for medical research.

And there is a particularly existential question that comes into play. If we are our memories, who and what are we if we can no longer make any? And it makes one wonder about new science that may offer us a way to erase traumatic memories, in the vein of the 2004 film Eternal Sunshine of the Spotless Mind.

Dittrich had an in, of course, but sometimes the family connection gets in the way. He tends to wax nostalgic about his grandfather, and wanders off topic for stretches. Some may enjoy these, and they were ok, I guess, but I found myself getting irritated at what seemed an excessive levels of detail, particularly in imagined scenarios. Thankfully, the eye-rolling portions of the book do not detract too much from the rest.

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Suzanne Corkin doggedly guarded her access to HM

There are clear similarities to be found between this book and two others that deal with medical history. The obvious comparison is to Rebecca Skloot’s best-seller The Immortal Life of Henrietta Lacks. In that cells that had been taken from a patient, and found to have remarkable qualities, were subsequently used, without permission, to support vast amounts of research. Ethical considerations raised in the book are considerable. But the much less well known Open Wound: The Tragic Obsession of Dr. William Beaumont, by Jason Karlawish, is the book that seems the most directly comparable. In that one, Dr. Beaumont of the title takes advantage of an unusual medical condition to keep a patient available for his research for a prolonged period. It raises similar ethical issues to the ones raised in Patient H.M..

Bottom line is that Luke Dittrich has given us a fascinating look at an obscure figure, bringing to life what medical progress actually looks like, and how much like sausage-making it really can be. He raises some very important ethical concerns not only about how Henry was treated as a person, but how access to Henry was handled, and how the information gleaned by researchers was guarded, and in at least one instance, destroyed. If you are at all interested in the brain and in the history of advances in medical knowledge, and do not take a look at Patient H.M. you should probably have your head examined.

Review Posted – 8/5/16

Publication date - 8/9/16

=============================EXTRA STUFF

More Material From Luke Dittrich
-----All Dittrich’s writings for Esquire, including a piece that takes aim at a neurosurgeon who claims he had gone to heaven.
-----A short version of Henry’s Story
-----Dittrich’s original Esquire article, The Brain that Changed Everyting
-----The Brain That Couldn’t Remember- NY Times Magazine – August 7, 2016

Jacopo Annese, oversaw the slicing of Henry’s brain post-mortem and digitizing of every bit into an image database. His institute created a 3D virtual model of Henry’s brain. Check out his site here.

This video shows HM’s brain being sliced at Dr. Annese’s facility. This process has been applied to many brains. Images of the slices are then digitized, and made available to researchers. Annese’s project has been referred to as the Google Earth of neuroscience. Find out more in this article about the work in ArsTechnica - To digitize a brain, first slice 2,000 times with a very sharp blade by Kate Shaw

If you want to know how one goes about removing a brain from a skull, the following article might prove mind-expanding. Cubed, Ground, Frozen or Marinated? 4 Scientists Talk Brain Dissection Styles by Linda Zeldovich on Braindecoder.com. No. Hannibal, not you.

Obit of Suzanne Corkin

An interesting article on research being done on the brain, noting just how little we really know - Probing Brain’s Depth, Trying to Aid Memory by Benedict Carey – July 9, 2014

A video on mapping the brain

An interesting op-ed on how mental health research resources are distributed - There’s Such a Thing as Too Much Neuroscience - by John Markowitz - October 14, 2016

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Reading Progress

May 23, 2016 –Started Reading

May 29, 2016 –Finished Reading

August 5, 2016 – Shelved as:science

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