Patient H.M.

Patient H. M.

Author: Luke Dittrich

Synopsis

This is a unique and even controversial biography of a person the author described as ‘the most studied individual in the history of neuroscience’ (page 8). Patient H.M., now known to be Henry Molaison, perhaps more than any other patient, helped to delineate how the brain functions. What adds poignancy to the book is that the author is the grandson of William Beecher Scoville, the larger-than-life neurosurgeon whose almost cavalier approach to brain surgery resulted in Henry’s total amnesia. The book brilliantly relates Henry’s life story, intertwined as it was, with the life of Scoville, demonstrating how his brain ‘revolutionised brain science’ (page 47).The picture the author paints however is ‘a dark one, full of the sort of emotional and physical pain, and fierce desires, that Patient H. M. himself couldn’t experience’.

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The author meticulously pieced together Henry’s life, detailing his intractable epilepsy that was treated with bilateral temporal lobectomy; this was the radical surgery that ‘transformed a forgettable boy from St. Peter’s school… into the unforgettable amnesic Patient H. M.’ (page 47). The book described the ‘brutal and stark’ amnesia that resulted from ‘the holes my grandfather dug in Henry’s brain’, regretting that Henry’s life ‘never progressed beyond the day in 1953‘ when Scoville ‘removed some small but important pieces’ of his brain (pages 44 and XIII). The devastating amnesia was such that Henry ‘told the same stories, over and over, but he always told them with equal enthusiasm’, and his inner state was ‘a constant feeling of having just emerged from a dream‘ (pages XII and 25). Because of the unique amnesia Henry manifested, he became a treasure trove for neuroscientists who endlessly probed him; ‘there were very few tests from the researchers’ arsenals that were not applied to Henry at one time or another. Every aspect of him was scrutinized, and the contours of his deficits were mapped out with increasing precision, day by day, year by year’ (page 311).

Anatomography – en:Anatomography (setting page of this image), CC BY-SA 2.1 jp, Link

The author also investigated his own family history, revolving around his colourful grandfather. William Scoville had initially trained as a neurologist but his love for neurosurgery led him to study under great surgeons such as James Poppen and Walter Dandy, ‘two of the best neurosurgeons of the day’ (page 51). The book narrates how Scoville ’embraced brain surgery… with all his heart’, possessing as it was the ‘the two frightening qualities‘ of neurosurgeons, ‘the will to make forcible entry into another human’s brain, and the hubris to believe you can fix the problem‘ (pages 52 and 13). He masterfully depicts how his grandfather’s experiments in psychosurgery pushed ‘deeper into uncharted territories of the human brain’, going from uncotomy and eventually complete medial temporal lobotomy (page 195). By the time his grandfather operated on Henry, the author said, he was already well on his way to becoming ‘one of the most prolific lobotomists in history’ (page 153).

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A major theme of the book is the author’s stringent denouncement of his grandfather’s unrestrained approach to neurosurgery generally, and Henry’s treatment specifically. For example, he rebuked his grandfather for proceeding with Henry’s surgery particularly because the electroencephalogram did not show any focus of seizures, adding that ‘if another neurosurgeon had been in my grandfather’s shoes that day, things might have turned out differently‘ (page 212). The author also described his grandfather’s decision to remove both medial temporal lobes as ‘the riskiest possible one for Henry’, saying ‘lacking a specific target in a specific hemisphere of Henry’s medial temporal lobes, my grandfather had decided to destroy both’ (page 213).

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As scathing as the author’s opinion of his grandfather was, his judgment of Suzanne Corkin was even more scorching. As the neuropsychologist who came to dominate Henry’s scientific and personal affairs, Corkin was also interestingly a childhood friend and neighbour of the author’s mother. The author detailed how Corkin, by ‘inheriting the world’s most important human research subject’, would come to dominate Henry’s academic and personal life. Whilst the author admitted that Corkin’s research elegantly demonstrated that there were two distinctive types of memory, declarative and procedural, he criticised her limited range of scientific interests, and what he saw as a self-serving and detrimental control of Henry’s affairs and legacy. Contrary to his disdainful views of Scoville and Corkin, the author acclaimed the contributions of other experts who were involved with Henry, such as the neurosurgeon Wilder Penfield,’the King of the mapmakers’, and neuropsychologist Brenda Milner, whose initial assessments of Henry firmly established the role of the medial temporal lobes in memory.

By Polygon data were generated by Database Center for Life Science(DBCLS)[2]. – Polygon data are from BodyParts3D[1], CC BY-SA 2.1 jp, Link
The book is full of interesting references to many notable neurologists, neurosurgeons and neuropsychologists who directly or indirectly determined Henry’s fate. These include Foster Kennedy, Heinrich Kluver, Stanley Cobb, Karl Lashley, Pierre Broca, Paul Bucy, Kenneth McKenzie, Victor Horsley, Wilder Penfield, Walter Freeman, Gottlieb Burckhardt, Egas Moniz, and Korbinian Brodmann. The book demonstrated how these neuroscientists all made their mark by studying disordered brains. Citing other notable neurological patients such as Phineas Gage and Monsieur Tan, the author remarked that ‘the history of modern brain science has been particularly reliant on broken brains‘ such as Henry’s (pages 90-96). 

By Polygon data were generated by Database Center for Life Science(DBCLS)[2]. – Polygon data are from BodyParts3D[1], CC BY-SA 2.1 jp, Link

Opinion

This is a unique book because the author explores several layers of the life of a remarkable patient. The author portrays the interesting, almost serendipitous, historical events and circumstances, that culminated in Patient HM. With tenacious journalistic probing, the author was able to unearth a lot more about the the man whose life has already been studied in detail. By exposing the human sides of all the key players, he has succeeded in painting a more complete, and perhaps more objective picture of the most famous patient in neuroscience. The book is particularly striking because the author was able to criticise those who most closely determined Henry’s fate. It is however perhaps unfair on Suzanne Corkin that the book was published after her death, denying her the opportunity to refute the author’s criticisms of her conduct.

 

Overall impression

This is an important book which gives a slightly different perspective on the life of Henry Molaison. It is quite enlightening in its historical details, and in many places it reads like a thriller, revealing the human aspects of all the players in Henry’s life. It takes an objective look at some of the accepted conclusions about Henry’s brain and personality, raising important questions about what we really know about memory. It looks at a critical stage of our understanding of the brain, intersecting as it does, the lives of some of the key players in the recent history of neuroscience. It is difficult to overestimate the value of Henry to neuroscience, and this book highlights this in very flowing prose. I highly recommend it to all doctors.

Book details

Publisher, Place, Year: Vintage, London, 2016
ISBN: 978-0-09957-186-5
Number of Chapters: 31
Number of Pages: 462
Price: £7.73
Star rating: 5

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