Patient H.M. (42 page)

She had moved to a new home not long before.

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 horrific. What she was telling me appeared to violate not just basic research ethics and scientific accountability but also something harder to articulate.

She was wrong about that. It wasn't just people like me. Later I told a number of scientists what Corkin had told me about her shredding of Henry's data. Almost all of them reacted with horror. In addition, some told me it fit a pattern in Corkin's behavior. Donald MacKay, the UCLA psychologist who had documented Henry's language deficits, said that the shredding was “not the first outrageous data protection strategy she's used.” In 2006, after Corkin had co-authored a paper about Henry's crossword puzzle performance, describing Henry as having “erudite puzzle-solving abilities,” MacKay wrote to Corkin requesting to see the actual puzzles she had based the paper on, since MacKay thought it was highly unlikely that Henry was in fact capable of high-level puzzle solving. Corkin refused to provide MacKay with the puzzles, and MacKay told me he'd sent a complaint to the American Psychological Association, since he considered such data hoarding to be a violation of research ethics.

Even as a nonscientist, I couldn't help notice that some of the unpublished data I'd come across while reporting this book went against the grain of the established narrative of Patient H.M. Take psychologist Liselotte Fischer's assessment of Henry, the one she conducted the day before the operation. Fischer's report is the only documentation of Henry's preoperative cognitive abilities. The report is three pages long, and over the years, small portions of it have been published, but most of it has not. When I saw it, some of the unpublished parts immediately leapt out. In describing Henry's attempts to grapple with arithmetic problems, Fischer wrote that, “in solving, or rather attempting to solve, simple arithmetic examples, he has immediate difficulties in recalling the tasks, then usually goes off on a wrong computation track, then recognizes this, but has forgotten the actual task.” Later Fischer concluded that, “while most areas of intellectual functioning, including Gestalt perception and abstraction, are intact, number concept and learning of new material are severely impaired, so that his functioning is grossly uneven.” In other words, Fischer's report provides evidence that on the day
before
the operation that transformed Henry Molaison into the amnesic Patient H.M., Henry's memory was “severely impaired.” This fact has, at best, only been hinted at over the years—the original 1957 paper about Henry, for example, mentioned that Henry had shown an “improvement in arithmetic” after the operation when measured against Fischer's preoperative testing, though the paper failed to mention that his preoperative struggles with arithmetic stemmed from an inability to recall the task at hand. More recently, Corkin wrote that although Fischer's testing of Henry had revealed a below-average ability to remember a random string of numbers, Henry's “deficits before the big event were likely a combined result of seizures and nerves.”

The causes and significance of Henry's preoperative memory deficits can be debated—were they the result of his anxiety, or his seizures, or some preexisting neurological condition?—but it seems hard to justify omitting Fischer's full report from the scientific record of the most important research subject in the history of memory science, which is what has been done. I wondered what other surprises might be found in a full accounting of Henry's unpublished 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 the essence of what was happening: My grandfather had cut a hole into Henry's memory, and now one of the many people who had profited from that act was cutting another hole, this one into our memory of Henry.

It occurred to me to ask Corkin another question I'd been wondering about. According to probate court documents, the Bickford Health Care Center had received all of Henry's Social Security and Medicaid payments, from which they disbursed to Henry exactly thirty dollars a month—less than a dollar a day—for his “personal needs.” “The MIT Research Project Known as Patient H.M.,” meanwhile, generated incalculable personal, professional, and financial benefits for Corkin and her colleagues. I had always thought that most people who participate as research subjects, at MIT or other universities, received payments for their time, and Henry had, by all accounts, spent more time as a research subject than anyone in history.

She paused again.

In other words: No.

On the way out of Corkin's office, I noticed a framed photograph of Henry's brain hanging on a wall. The photo was beautifully lit, professionally shot. It had been taken in Annese's lab, right after the night Annese had peeled the brain, removing the various membranes that had cloaked it, leaving it fully exposed. The brain was, in its own way, beautiful, even if you divorced it from context, even if you didn't know who it belonged to or what it had taught us. Even if you didn't know anything about its story.

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. It had a squat but aerodynamic profile: The frontal lobe angled down toward the surface like the nose of a sports car. A gentle curve sloped back from there, up and over the top of the cortex before dropping down again toward the rear, flaring inward at the base of the occipital lobe, then flaring outward around the thick foundation of the cerebellum. The surface of the brain, the portion visible in profile, was a labyrinth: ropey tubes of gyri folded over each other in complex, compact ways, sulcal trenches dividing them. Within the tangle of sulci and gyri there were other, broader and more subtle demarcations, including the one between the temporal lobe and the frontal lobe. You might, with an educated eye, notice that the cerebellum was smaller than most, withered away by years of Dilantin, but the real damage, the lesions that transformed Henry Molaison into Patient H.M., was not visible in the photo. The outer portion of Henry's temporal lobes was intact; my grandfather had only destroyed their innermost medial structures. To see that destruction, that vacuum, you'd have to flop the brain over onto its side, exposing its underbelly. In the photograph that hung on Corkin's wall, Henry's brain looked like yours, or hers, or mine, or anyone's.

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 had 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 lightbulb; more like an oyster.

That didn't strike me as right either, though.

It's not a pneumatic pump, a telephone switchboard, or a tape recorder.

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, at those ripples like molten copper, and tried to commit the moment to memory.

O
n a cold, windy morning in Connecticut—the car radio told me the city was experiencing twenty-year lows—I visited Hartford Hospital. I'd made an appointment to meet the hospital's archivist, and he'd prepared for the meeting by rounding up a bunch of my grandfather's old neurosurgical tools. He'd found them in storage. He brought them into a conference room, in a cardboard box, and placed them on the table. I pulled them out one by one.

There was a brace that looked almost like orthodontic headgear and could be adjusted with butterfly screws.

There were a handful of Scoville clips, used for pinching off aneurysms, made of an iron alloy called austenite.

There were oddly bent scissors, designed to deal with the tricky angles neurosurgeons navigate when cutting through veins or membranes.

There were scythe-shaped tools, probably hand-soldered by my grandfather, and some long, piercing tools like awls.

There were a few trephines, those circular bone drills with their raw, serrated edges.

Everything had been sitting untouched for years, if not decades, and many of the tools were flecked with bits of reddish rust.

At the bottom of the box I found a strange pair of glasses. They looked like 1950s-style horn-rims, but they had long magnifying lenses attached to the tops of the regular lenses: surgical loupes. It occurred to me that the last person to wear them had been my grandfather. I tried them on.

They were too small for me, and the sides clamped hard against my head. When I first put them on, my eyes naturally settled their gaze through the main lenses, which seemed to be just plain glass, no prescription. Then I shifted my eyes up, looking through the loupes. It took a few moments to adjust. I held my hand out in front of me. At two or more feet away, it was just a pinkish blob, like looking at a shell underwater without a diving mask. I moved it closer, and at about eighteen inches my hand began to materialize into a recognizable form. A foot away was the sweet spot. At that distance, my hand looked gigantic but incredibly sharp. I could only see a small patch of it at a time, though, and slowly scanned over my skin's alien topography. Looking through the loupes, I found that my field of vision was magnified but extremely narrow. I could make out the individual ridges on my fingertips, but everything else was a blur.

I made that visit to the hospital a long time ago, during my first reporting trip to Hartford, back when I was just beginning to look into the story of Patient H.M. A decade has passed. But still: I can imagine it. I can conjure up little scraps of the scene, flashes of how it felt looking through my grandfather's loupes in that conference room, on that chilly morning. I'm here and I'm there all at once.

And here, now, looking back at the beginning of this story from the very end of it, I'm thinking about my grandfather, about the people he helped and the people he hurt. I'm thinking how, when he put on those strange glasses and leaned in, all context, all sense of place, had to have just melted away. All he could see was what was right in front of his eyes.

I'm thinking about Henry. About what he sacrificed for us, and what we gave him in return. I'm thinking how, for all that separated my grandfather and him, that tight, constricted field of view was something they had in common. The holes my grandfather made in Henry's brain marooned Henry on a small island where all he had, all he could see, was a sliver of the present, a place where the past and the future were nothing but indistinct blurs. Unlike my grandfather, though, Henry had no choice but to see the world that way.

I'm thinking about some of the people who studied Henry. Brenda Milner, Suzanne Corkin, Jacopo Annese. How each took something from Henry's loss, and eventually each, in turn, lost Henry.

I'm thinking about John Fulton, Charles Burlingame, Walter Freeman.

I'm thinking about monkeys, and I'm thinking about men.

I'm thinking about women: Patient A.R., Patient R.B., Patient G.D. Hundreds more. Thousands.

I'm thinking about my grandmother, Bambam.

I'm thinking about my mother, my sisters, my daughter.

I'm thinking about how some stories are just the opposite of how things looked through my grandfather's loupes. Some stories, the longer you look at them, the wider their lenses become and the more they start pulling other parts of the world into view. Other people, other places, other times, all swirling together before they slip away, like when you're just waking from a dream.

Ninety-three-year-old Karl Pribram moved in his chair and groaned again and looked like he was trying to get up.

Marlene, his caregiver, asked if he needed to go to the bathroom or if he wanted lunch.

“Not particularly,” he said, and settled back down. He looked at me. “A lot of different things are happening, and I'm not sure what I'm supposed to be doing. Am I supposed to be answering your questions?”

After he'd told me what he remembered my grandfather doing to my grandmother, Pribram had begun telling me about the day he first met Henry. We'd been talking for a while by this point, and he was getting foggier. People who undergo cancer treatment often develop memory problems, a result of the damage chemotherapy drugs do to the hippocampus. Pribram was trying to tell me his story of meeting the world's most famous amnesic, but he was struggling under the weight of his own failing memory, and his sentences were becoming a jumbled pile of fragments. As best as I could tell from what he'd said so far, sometime not long after Henry's operation Pribram had walked the short distance from his monkey lab at the Institute of Living to my grandfather's office at Hartford Hospital. He had arranged to meet Henry, and he was eager to do so. After all, this was a human being who had just received the same sorts of lesions that Pribram back then spent his days making in the brains of macaques. My grandfather introduced the two men, then excused himself, since he had been called to attend to another patient. Pribram and Henry were left alone. They began chatting. They talked for a while and eventually discovered they had something in common. They each, it turned out, dreamed of one day making an overland trip from Cairo to Cape Town.

“You were telling me about the day you met H.M.,” I reminded Pribram. He nodded, then began to speak. His words came slowly. Short sentences, long pauses between each one.

I'll tell you exactly what happened.

H.M. and I were talking. And Bill was called out.

I guess Bill was there, too.

Bill was called out of the room. And we were left together. And I was.

Bill had to go out, was called out on a case. H.M. and I were left together. And we discussed our Cape Town–to-Cairo things that we were both so much interested in.

And Bill had to go do something else.

H.M. and I were left alone. And kept talking about Cape Town to Cairo.

He was called out. Scoville was called out for something.

And I was left with H.M.

So we kept talking about the whole Cape Town–to-Cairo business.

And then Scoville was called out and H.M. and I were left alone.

And we talked about our mutual interest in Cape Town to Cairo.

And then Scoville was called out of the room.

And H.M. and I were left alone.

And I remember vividly.

What happened was.

Something like.

Whatever was going on.

Called out of the room.

Came back in.

And H.M. said, “Have you been in here before?”