Patient H.M. (6 page)

Throughout the exchange, Henry's tone never changed. He spoke in the same soft, gentle, halting voice that he used when discussing almost anything and never betrayed any obvious sadness when the scientist confirmed to him, for both the thousandth and the first time, that his father was dead. One day during another similar session, Henry carefully wrote a note to himself on a scrap of paper that he began carrying with him in his shirt pocket wherever he went.

“Father's dead,” the note read. “Mother's in a hospital, but she's well.”

Arline Hallissey went to work, like her father, at the Hartford Police Department. She became one of the city's first meter maids. She remembers walking her beat, looking at the parked cars, noting the baby seats or the coffee cups or the paperwork or whatever else was visible inside and trying to imagine who the cars' owners were, what their lives were like, where they worked, how many children they had, their dreams and ambitions.

When I spoke with her she'd been retired a long time. She wasn't in great health. She sounded frail. She told me she had small seizures sometimes. It was something the doctors hadn't been able to pin down.

“I'm perfectly normal otherwise,” she said. “But you know what the brain does. It does what it damn pleases.”

Most of us have brains that work tirelessly, in dreams and in wakefulness, following their own mysterious routines. They absorb and process our experiences, they present and preserve our own personal worlds. Sometimes they grow ill, sometimes they grow cancerous, sometimes they simply grow old. But most of them do so according to their own mandates, far beyond our control. Most of us have brains, in other words, that do what they damn please.

Henry Molaison did not.

From the day of his operation and until the day of his death, Henry's brain could no longer follow its own natural inclinations. Many of its essential circuits had been disrupted or sealed off, and the impact of this intervention was persistent and ubiquitous. After its surgical transformation, Henry's brain, rather than doing what it damn pleased, was able to do only what it could, under radically altered and diminished circumstances.

That transformation of Henry's brain is what transformed a forgettable boy from St. Peter's school, whose own boyhood crush didn't even remember him, into the unforgettable amnesic Patient H.M. Scientists would end up studying almost every aspect and implication of Henry's brain, and what they learned revolutionized brain science.

The story of what they learned from Patient H.M. and his incomplete brain, however, is itself greatly diminished without first learning the story of what led my grandfather to make those devastating, enlightening cuts. That story is a dark one, full of the sort of emotional and physical pain, and fierce desires, that Patient H.M. himself couldn't experience. It's a story that's never been told, and even now, fingers on the keyboard, I hesitate.

T
here were people in the cellar. My grandmother could hear them. She had thought she was alone in the house, except for her children, who were asleep in their bedrooms. Now it appeared she was wrong. The children were asleep and my grandmother was not and she could hear people in the cellar.

She was terrified.

It was late January 1944, in a comfortable single-family home on Frankland Street in Walla Walla, Washington. My grandfather, as usual, was at work, this time on an overnight shift at the U.S. Army's McCaw General Hospital, where he served as chief of neurosurgery. Just the day before, he had come back from a weeklong conference in Spokane. They had been married for ten years, and it had always been like that, his career constantly pulling him away.

Their wedding took place during the final year of his internship at Hartford Hospital, and in 1935 they moved from Hartford to Ithaca, New York, where my grandfather became an assistant resident in psychiatry at Cornell University. From there it was on to Manhattan, where he completed a residency in neurology at Bellevue Hospital. A neurosurgery residency at Massachusetts General Hospital followed soon after, and from there, in quick succession, he completed residencies and appointments in three other hospitals and clinics, from Baltimore to Boston, honing his skills under James Poppen and Walter Dandy, two of the best neurosurgeons of the day, before returning to Hartford in 1939, where he founded Hartford Hospital's neurosurgical department. Neurosurgery quickly became a calling, not just a job. “Neurosurgery was my great desire,” he'd write years later. “I couldn't stand the meditation in Neurology and Psychiatry in those days. The technical perfection of Poppen and a summer with Dandy thrilled and excited me. How could anyone choose any other specialty; cardiac surgery—only a pump; thoracic surgery—only a ventilator; orthopedic surgery—such crude instruments; urology—a sewage system appealing to the more morbid followers of Freud.” He embraced brain surgery—that most difficult, demanding, and consequential of medical specialties—with all his heart.

He had been a practicing neurosurgeon for five years when the U.S. Army called him up for active duty and made him a major in the Medical Corps. He began his military career stationed at Walter Reed General Hospital in Washington, D.C., though he'd often make long-distance house calls, like when he was once flown on a bomber to the arctic airbase in Goose Bay, Labrador, to treat a head injury in the middle of winter. In 1943, the army ordered him to report to the opposite coast, in Walla Walla. There he spent his days treating the battered soldiers coming home from the South Pacific. He was good at his work, and his work energized and elevated him. The self-doubt of his college years had evaporated, replaced by a new self-confidence and a wry, upbeat outlook on life. That year, when Yale solicited all members of the class of 1928 to submit a one-sentence summation of their guiding philosophies, my grandfather wrote the following: “We are simply a fancy edition of the little flowers and fishes and should not get as wrought up as Hitler has about it all.”

Meanwhile, my grandmother managed. As her husband found his passion and ascended professionally, she tried to adjust to the demands of raising her family three thousand miles from home. They had three kids, each two years apart. By 1944 the oldest, Barrett, was eight, and the youngest, Peter, was four. My mother, Lisa, was in the middle, six years old. My grandfather ran his operating rooms and my grandmother ran the household, attending to the day-in, day-out practicalities: school, meals, cleaning. She managed, but with each kid it got a little harder, and the past year had been the hardest. My grandfather had left for Walla Walla two months before she had, leaving her to handle most of the work of moving. She and the children ended up driving across the country in a Lincoln Continental convertible. Then she settled into her new life, in this new place, raising my mother and my uncles pretty much on her own as before, although now she was doing it without her support system, her family and friends. In the past several months, her weight had dropped from 108 pounds to 89. She'd always been thin, but it had gone beyond that.

And now there were people in the cellar. Or, she realized, there
had
been people in the cellar. They had migrated upstairs, and suddenly she could hear them behind one of the closed doors. She recognized the voices. They belonged to some of the only people she'd made friends with here. People who lived in the neighborhood, not far away. What were they doing there? She listened to the voices, tried to make out what they were saying. She caught only vague snatches, but it was enough to convince her that something terrible was looming. Some sort of plot against her and her husband. Her friends, the ones who snuck into her house, were whispering. She didn't dare open the door. The night passed slowly.

When she awoke the next morning, she wondered whether any of it had been real. Had she been dreaming? There hadn't really been people in the house, had there? At six
A.M.
, before the children were awake, she slipped outside and rode her bicycle a few blocks to the house of the whispering friends. She rang the doorbell and waited for them to answer, to make sure they were there and not hiding somewhere in her own home. When they answered she hurriedly said she had to go, couldn't stay, and then she got back on the bicycle and rode back to start preparing breakfast. It was Saturday, and the children didn't have school, so she needed to tend to them.

As the morning unfolded, she called her husband three times. Each time she was told that he was busy performing an operation and couldn't call back till later, but something inside of her told her that this was a lie. They were lying to her. Her husband was not in surgery. Her husband was in jail. He had been court-martialed. They had him.

She did not know what to do, but she knew she had to do something. She tried to keep busy. She went upstairs, she went downstairs. She watched her children play. She noticed her youngest, four-year-old Peter, was not playing. He was not playing, and he was looking at her. He was looking at her and making motions with his hands. He was trying to tell her something without words. Just as she did the night before, when she tried to decipher the whispers behind the door, she tried to decipher Peter's hands. At first she didn't understand, but then suddenly she did, and she knew what she had to do.

She gave her children their lunch, then sent them off to play with some friends. Once they left, she walked to a neighbor's garage and went inside. There was a car in the garage, and she clambered up on top of it. She removed the shirt she was wearing. She began to tear the shirt into long strips of fabric, then tied the long strips of fabric together. This was what Peter had been pantomiming with his hands. This was what he had wanted her to do.

When she was done, she reached up and tied one end of the rope she had just made to a beam in the garage and placed the other end, the noose, over her head.

A neighbor found my grandmother standing there, half undressed, trying to kill herself with her handmade rope. The neighbor placed a phone call. My grandfather came home from the hospital at about three
P.M.
, and my grandmother began telling him everything, about the plot and the court-martial and the whispering friends, about how what she had tried to do was for everyone's good, that it was the only way for her to stop the darkness from spreading. He listened to her, shocked. There had been no signs. None that he had seen, anyway. None that anyone had seen, for that matter. It was as though he and his wife had inhabited the same world all of their lives together, and then, with no warning, she departed for a new one. A world completely invisible to him.

They went to the hospital together. A psychiatrist interviewed her. They checked her in to an open ward. My grandfather stayed with her that night in her bed, while someone stayed home with the children. She was affectionate with him, imploring him to make love to her, but then became agitated, emotional, confused. In the middle of the night she got up out of bed and wandered into another room on the ward. There was a woman lying in a bed there. My grandmother stood at the bedside for a moment looking down at her.

“Why do you lie there in women's clothing?” she said, and slapped the patient across the face.

They restrained her. They took her to a closed ward, one where she was not free to wander. They kept her there for two months while my grandfather made arrangements for a longer-term solution. Her condition varied from day to day, week to week. She cried for hours and hours. She reported that someone had killed her children, that their heads were buried in the walls of her room. She reported that events too terrible to describe were taking place just beneath her floor. For the first ten days she refused to eat, claiming that the food they brought was contaminated with white lead. When my grandfather visited, she accused him of selfishness, of sleeping with other women, of giving her nothing but loneliness since the day they married.

On March 25, 1944, an ambulance took her from the closed ward to the train depot, and soon the entire family boarded a train for a three-day cross-country trip back home to Connecticut. The children were not aware of what was happening. They knew their mother had been somewhere else, and they knew they were now being tended to by a cartoonishly stern nanny, Mrs. Thornfeldt, but the details, the whys, were out of reach. A neighbor had given them a large bag filled with packages to take on their trip. They'd open a new one each morning, revealing a fresh gift for every day on the rails. They knew their mother was on the train with them, but they didn't know why she'd been confined to a locked drawing room. My grandfather visited her in the drawing room. He watched her chain-smoke. He watched her eat. Eventually he gave her several doses of Luminal and watched her sleep.

Three days after leaving Walla Walla, the train pulled into Hartford. A car was waiting for my grandmother at the station. It was just a short drive from there to the asylum.

In 1858, the president of the Connecticut State Medical Society gave a speech in which he recalled a scene from his childhood, fifty years earlier: “Travelers passing through the town of Farmington on the road to Hartford,” he said, “would observe a little cage set in a bank near the turnpike, occupied by a raving maniac, staring and shouting to the passing travelers; subsequently he was removed to a barn nearby, where he sat crouched on his limbs till they inflamed and adhered together so that he could not be straightened. Here he sat year after year, covered over with an old blanket, and had his food given him as it was to the chickens in the barnyard. This is not mentioned as a reproach to the good people of Farmington, there being few towns whose inhabitants have a more enviable reputation for morality and true religion. Other cases perhaps as revolting existed in other towns.”

His point was that those days had passed and that mentally ill men and women in Connecticut were no longer locked in roadside cages or, as had also once been common, bought and sold as cut-rate slaves, human damaged goods. Instead they now had a place to go. A welcoming place, one where they could experience a sort of treatment far removed from the hell on earth they'd once had to endure. That place was my grandmother's asylum, which was then known as the Hartford Retreat for the Insane. Ever since its founding in 1822, the institution had presented itself to the world as being among the most progressive asylums on earth. Its first superintendent, in a “Report of the Committee Respecting an Asylum for the Insane,” which was delivered to the Connecticut General Assembly just prior to the opening of the institution, declared that the Hartford Retreat aspired to be “the reverse of everything which usually enters into our conceptions of a madhouse.” Instead of just being a sort of jail where “the unfortunate maniacs are confined,” his asylum would be dedicated to the “moral management” of the inmates.

In many ways, he succeeded. Patients at the Hartford Retreat, unlike the unfortunates who might have once wound up shackled in the dungeons of Bethlem or forgotten in the back ward of Bellevue, were given a chance to lead almost normal lives. They could walk the verdant grounds, eat communally in a gracious dining hall, attend religious services, and even participate in the drafting of the world's first newspaper ever produced in an asylum,
The Retreat Gazette.
The governor of Connecticut was a subscriber to the
Gazette
and remarked that the publication was “more rational than many papers I have lately seen, emanating from quarters much less suspicious so far as the seal of public reprobation is concerned.”

The asylum didn't offer many treatments during those early years. Its founders believed that the best thing to do for the mentally ill was to simply provide them with a stimulating but pleasant environment, full of time-consuming but not too taxing activities. They hoped that if patients were kept busy while being sheltered from the stresses of their everyday lives, their problems would take care of themselves. Patients dressed in street clothes, as did their attendants, and unless residents were particularly violent or uncontrollable they were not confined with chains or anything else. Charles Dickens, who visited the asylum as a journalist in 1842, was struck by this. “I very much questioned within myself, as I walked through the Insane Asylum, whether I should have known the attendants from the patients, but for the few words which passed between the former, and the Doctor, in reference to the persons under their charge. Of course, I limit this remark merely to their looks; for the conversation of the mad people was mad enough.” He goes on to recount one such conversation:

There was one little, prim old lady, of very smiling and good-humoured appearance, who came sidling up to me from the end of a long passage, and with a curtsey of inexpressible condescension propounded this unaccountable inquiry:

“Does Pontefract still flourish, sir, upon the soil of England?”

“He does, ma'am,” I rejoined.

“When you last saw him, sir, he was—”

“Well, ma'am,” said I, “extremely well. He begged me to present his compliments. I never saw him looking better.”

At this the old lady was very much delighted. After glancing at me for a moment, as if to be quite sure that I was serious in my respectful air, she sidled back some paces; sidled forward again; made a sudden skip (at which I precipitately retreated a step or two); and said:

“I am an antediluvian, sir.”

I thought the best thing to say was, that I had suspected as much from the first. Therefore I said so.

“It is an extremely proud and pleasant thing, sir, to be an antediluvian,” said the old lady.

“I should think it was, ma'am,” I rejoined.

The old lady kissed her hand, gave another skip, smirked and sidled down the gallery in a most extraordinary manner, and ambled gracefully into her own bed-chamber.