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Summary
Summary
"Oliver Sacks meets Stephen King"* in this propulsive, haunting journey into the life of the most studied human research subject of all time, the amnesic known as Patient H.M., a man who forever altered our understanding of how memory works--and whose treatment raises deeply unsettling questions about the human cost of scientific progress. For readers of The Immortal Life of Henrietta Lacks comes a story that has much to teach us about our relentless pursuit of knowledge.
* Kirkus Reviews (starred review)
NAMED ONE OF THE BEST BOOKS OF THE YEAR BY THE WASHINGTON POST
In 1953, a twenty-seven-year-old factory worker named Henry Molaison--who suffered from severe epilepsy--received a radical new version of the then-common lobotomy, targeting the most mysterious structures in the brain. The operation failed to eliminate Henry's seizures, but it did have an unintended effect: Henry was left profoundly amnesic, unable to create long-term memories. Over the next sixty years, Patient H.M., as Henry was known, became the most studied individual in the history of neuroscience, a human guinea pig who would teach us much of what we know about memory today.
Patient H.M. is, at times, a deeply personal journey. Dittrich's grandfather was the brilliant, morally complex surgeon who operated on Molaison--and thousands of other patients. The author's investigation into the dark roots of modern memory science ultimately forces him to confront unsettling secrets in his own family history, and to reveal the tragedy that fueled his grandfather's relentless experimentation--experimentation that would revolutionize our understanding of ourselves.
Dittrich uses the case of Patient H.M. as a starting point for a kaleidoscopic journey, one that moves from the first recorded brain surgeries in ancient Egypt to the cutting-edge laboratories of MIT. He takes readers inside the old asylums and operating theaters where psychosurgeons, as they called themselves, conducted their human experiments, and behind the scenes of a bitter custody battle over the ownership of the most important brain in the world.
Patient H.M. combines the best of biography, memoir, and science journalism to create a haunting, endlessly fascinating story, one that reveals the wondrous and devastating things that can happen when hubris, ambition, and human imperfection collide.
Praise for Patient H.M.
"An exciting, artful blend of family and medical history." -- The New York Times
"In prose both elegant and intimate, and often thrilling, Patient H.M. is an important book about the wages not of sin but of science." -- The Washington Post
"Spellbinding . . . The fact that Dittrich looks critically at the actual process of scientific investigation is just one of the things to admire about Patient H.M." --The New York Times Book Review
" Patient H.M . tells one of the most fascinating and disturbing stories in the annals of medicine, weaving in ethics, philosophy, a personal saga, the history of neurosurgery, the mysteries of human memory, and an exploration of human ego." --Sheri Fink, M.D., Pulitzer Prize winner and author of Five Days at Memorial
"Dittrich explores the limits of science and the mind. In the process, he rescues an iconic life from oblivion. Dittrich is well aware that while we are the sum of what we may remember, we're also at the mercy of what we can forget. This is classic reporting and myth-making at the same time." --Colum McCann, author of Let the Great World Spin
Author Notes
Luke Dittrich is a National Magazine Award-winning journalist, and a contributing editor at Esquire . This is his first book.
Reviews (4)
Publisher's Weekly Review
In this courageous mix of scientific investigation and memoir, journalist Dittrich recounts the life of Henry Molaison (1926-2008), an epileptic man hailed by many as the most important human research subject in the history of neuroscience. A 1953 operation by Yale neurosurgeon William Beecher Scoville (1906-1984), Dittrich's grandfather, on Molaison's hippocampus left the 27-year-old without memory, in a world where "every day is alone in itself." The story of "what led my grandfather to make those devastating, enlightening cuts," Dittrich writes, "is a dark one, full of the sort of emotional and physical pain, and fierce desires, that Patient H.M. himself couldn't experience." And he unravels it by documenting the decades-long studies Molaison's extraordinary amnesia spawned and the researchers he would inspire and confound. Those threads are woven around the history of neurosurgery-including the professional infighting that can obscure the legacy of scientific advances and failures, the torturous mid-20th-century treatment of the mentally ill, and the rise and fall of lobotomies. At the heart of this breathtaking work, however, is Dittrich's story of his complicated grandfather, his mentally ill grandmother, and a long-held family secret, with Molaison stranded "where the past and the future were nothing but indistinct blurs." Agent: Sloan Harris, ICM. (Aug.) © Copyright PWxyz, LLC. All rights reserved.
Booklist Review
*Starred Review* Be warned that this foray into neurological medicine is not for the faint of heart. Littered with lobotomies, mentally ill men and women in asylums, shock treatments, and cruel research, the landscape of neurology, psychiatry, and neurosurgery in the twentieth century has a distinctly ugly side. Henry Molaison, known as Patient H.M., is labeled the most studied individual in the history of neuroscience. He suffered from epilepsy since childhood, and despite large doses of anticonvulsant medications, he experienced worsening seizures. Enter Dr. William Scoville, the author's grandfather, who performs an experimental operation, bilateral medial temporal lobotomy, to quell Molaison's seizures in 1953. Scoville, a daring neurosurgeon, does as many as five lobotomies a day and likely lobotomized his own wife, who suffered from psychosis! Over four decades, Molaison often stayed at a MIT research center, where he was studied for his profound postoperative amnesia. Two psychologists and a neuroanatomist also play important roles in the drama journalist Dittrich reveals. The workings of memory are a major theme: Memories make us. Everything we are is everything we were. But the machinations of scientists and researchers their personality and ambition, power and hubris are of equally vital (and cautionary) importance in Dittrich's unusual and compelling mix of science and family history.--Miksanek, Tony Copyright 2016 Booklist
New York Review of Books Review
ON AUG. 25, 1953, a Connecticut neurosurgeon named William Beecher Scoville drilled two silver-dollar-size holes into the skull of Henry Molaison, a 27-year-old man with epilepsy so severe he had been prohibited from walking across stage to receive his high school diploma. Scoville then used a suction catheter to slurp up Molaison's medial temporal lobes, the portion of the brain that contains both the hippocampus and the amygdala. The surgeon had no idea if the procedure would work, but Molaison was desperate for help: His seizures had become so frequent that it wasn't clear if he would be able to hold down a job. As it happened, Scoville's operation did lessen Molaison's seizures. Unfortunately, it also left him with anterograde amnesia: From that day forth, Molaison was unable to form new memories. Over the course of the next half-century, Patient H.M., as Molaison was referred to in the scientific literature, was the subject of hundreds of studies that collectively revolutionized our understanding of how memory, and the human brain, works. Before H.M., scientists thought that memories originated and resided in the brain as a whole rather than in any one discrete area. H.M. proved that to be false. Before H.M., all memories were thought of in more or less the same way. H.M.'s ability to perform dexterous tasks with increasing proficiency, despite having no recollection of having performed the tasks before, showed that learning new facts and learning to do new things happened in different places in the brain. It's no exaggeration to say that Molaison is one of the most important patients in the history of neurology; it's likely he was also the most studied experimental subject of all time. The broad strokes of this story are well known. In 2008, when Molaison died and his name was finally revealed to the public, it was front-page news. Several well-received books have already been written about Molaison, including one published in 2013 by Suzanne Corkin, the M.I.T. neuroscientist who controlled all access to and oversaw all research on Molaison for the last 31 years of his life. What else, you might wonder, is there to say? According to the National Magazine Award-winning journalist Luke Dittrich, plenty. Dittrich arrived at Molaison's story with a distinctly personal perspective - he is Scoville's grandson, and his mother was Cor kin's best friend growing up - and his work reveals a sordid saga that differs markedly from the relatively anodyne one that has become accepted wisdom. "Patient H.M.," the overstuffed result of Dittrich's six years of reporting, tries to be many things at once: a lyrical meditation on the nature of memory, an excavation of a disturbing and dark family history, and a damning illustration of the consequences of sacrificing ethics in the name of scientific inquiry. The end result is both spellbinding and frustrating, a paradox of a book that is simultaneously conscientious and careless, engrossing and digressive, troubling and troublesome. This push-pull is present from the opening section, where Dittrich most obviously (and distractingly) tries to mimic in his narrative the "endless little leaps of time travel during our daily lives" caused by memory. One chapter, which starts and ends atop the George Washington Bridge in 1930 and makes a pit stop at the pyramids in Egypt, includes digressions on the start of Dittrich's career, his love of Lawrence Durrell's "Alexandria Quartet" and the record for highest high dive. Fortunately, Dittrich hits his stride a few chapters later. The story picks up in 1944, several years before Scoville first meets Molaison, when Scoville; his wife, Emily; and their three young children are living in Washington State. What appears at first to be a cozy picture of suburban life takes a sudden, tragic turn when Emily imagines that her 4-year-old son is sending her coded messages to kill herself. This is just the first in a string of vertiginous revelations that Dittrich successfully threads throughout "Patient H.M." Within a few months of Emily's breakdown, the entire Scoville family had moved to Connecticut, where Emily was institutionalized and subjected to a host of the inhumane treatments used on the mentally ill in mid-20th-century America: At one point, she was submerged in a tub of cold water for hours at a time; at another, she was locked in a "copper coffin and cooked" until her temperature reached 105 degrees. (Throughout the book, the visceral horror of what Dittrich describes is well served by his rat-a-tat-tat, neo-noir style.) Scoville, meanwhile, had become a vocal proponent and prolific performer of psychosurgeries; by the time he began treating Molaison in the mid-1940s, he was a participant in a study that lobotomized mentally ill patients in the hope of easing overcrowding in Connecticut's asylums. But it wasn't until 1953 that Scoville drilled into Molaison's skull. Why the delay? One obvious answer is that Scoville had initially tried, and failed, to control Molaison's seizures with medication. Dittrich speculates that there was another, more sinister explanation. In the era of early brain mapping, when identifying the function of a specific region could secure lasting glory, Scoville had become frustrated with the limitations of operating on patients with acute psychological problems. What could removing a portion of the brain in someone who wasn't "normal" possibly tell him about the role of that area in someone who was healthy? Molaison, however, was psychologically intact - but the locus of his seizures was unknown. "Lacking a specific target in a specific hemisphere of Henry's medial temporal lobes, my grandfather had decided to destroy both," Dittrich writes in one of the book's many chilling passages. "The risks to Henry were as inarguable as they were unimaginable. The risks to my grandfather, on the other hand, were not. At that moment, the riskiest possible option for his patient was the one with the most potential rewards for him." This is heavy stuff: Dittrich ultimately puts his grandfather's actions on a continuum with those of Nazi doctors who tortured Jews to test the limits of human endurance. While that comparison is a bit strained - Molaison was, after all, a willing patient who was actually sick - Dittrich does make a convincing (if implicit) case that Scoville violated the Nuremberg Code adopted in the wake of World War II to govern research on humans. DITTRICH'S RIGHTEOUS indictment of his own grandfather is undeniably powerful. Of the two most compelling accusations of medical and scientific misconduct in "Patient H. M.," it's also the one that has been aired before. But Dittrich also raises a number of issues relating to Suzanne Cor kin's actions, including whether she properly received informed consent for her tests on Molaison, that have not been addressed in public previously - and in many ways these are just as unsettling. Corkin, who died of liver cancer in May, first encountered Molaison in the 1960s, when she was a graduate student in Montreal, but it wasn't until 1977 that she fully took over his case. Over the following decades, Corkin and more than 100 collaborators conducted countless experiments, many of which involved activities a typical test subject would find invasive or unpleasant: In one, Molaison was fed multiple meals in a row to see if he remembered just having eaten; in another, he was burned repeatedly to test his pain threshold. The entire reason Molaison was given these tests was that he was incapable of remembering more than 20 or 30 seconds in the past - and yet for 12 years, from 1980 until 1992, Molaison signed his own consent forms. At that point, Dittrich writes, Corkin arranged for the son of Molaison's former landlady, who may have been a distant relative, to serve as his conservator despite the fact that Molaison had several first cousins living nearby. Dittrich also appears to have uncovered evidence that Corkin's published work painted an incomplete picture of Molaison. In her book, Corkin described Molaison as carefree and easygoing, a sort of accidental Zen master who couldn't help living in the moment. In one of her papers, which makes reference to but does not quote from a depression questionnaire Molaison filled out in 1982, Corkin wrote that Molaison had "no evidence of anxiety, major depression or psychosis." Dittrich located Molaison's actual responses to that questionnaire, which had not been included in Corkin's paper. Among the statements Molaison circled to describe his mental state were "I feel that the future is hopeless and that things cannot improve" and "I feel that I am a complete failure as a person." That disclosure raises the question of whether there is more unpublished information that could yield new insights into Molaison. Corkin, however, told Dittrich in a recorded interview that she was shredding her files on Molaison lest future researchers misinterpret her data. When several of these revelations appeared in a New York Times Magazine excerpt from Dittrich's book, Corkin's former colleagues, at M.I.T. and elsewhere, cried foul. The question of whether files were actually destroyed remains unsettled, while the issue of informed consent has not yet been addressed. (I am a professor at M.I.T.; I did not know Corkin and don't know any of the principals involved in the response to Dittrich's work.) THE FACT THAT Dittrich looks critically at the actual process of scientific investigation is just one of the things to admire about "Patient H.M." It also makes its most glaring shortcoming all the more incomprehensible: This deeply reported, 400-page book, which aims to reframe one of the best-known medical case studies of the 20th century, is devoid of either source notes or a bibliography. That's inexcusable: Given the number of ways in which Dittrich's narrative differs dramatically from what's been published before, he has a responsibility to show readers how he came to his conclusions. Dittrich has a sterling reputation as a reporter - but he no more than Corkin or any other scientist or journalist gets to use "trust me" as a substitute for evidence. (The total absence of supporting material also leaves Dittrich vulnerable to questions about his vigilance. He got the year wrong on the one paper of Corkin's I happened to look up, and when I randomly checked a single fact in the book - that the Claridge Hotel was the tallest building in New Jersey in 1951 - I found it to be incorrect as well.) Molaison has long been portrayed as the victim of a surgeon's hubris. Dittrich's book, and the reaction to it, highlight why the lessons learned from his life cannot be limited to those stemming from a single act in the distant past. It's easy to criticize the arrogance of researchers after they're dead - and after we've already enjoyed the fruits of their work. With most of the principals in the tragedy of "Patient H.M." now gone, the question at the core of Dittrich's story - did the pursuit of knowledge conflict with the duty of care for a human being? - remains, in every interaction between scientist and vulnerable subject. SETH MNOOKIN, the director of M.I.T.'s graduate program in science writing, is the author, most recently, of "The Panic Virus."
Library Journal Review
In 1953, Henry Molaison, suffering from intractable epilepsy, underwent a fashionable new treatment that pioneering surgeons believed might resolve a host of conditions ranging from schizophrenia to homosexuality. This treatment, the lobotomy, had as one of its leading proponents and practitioners William Scoville, who performed the surgery on Molaison and who happens to be the grandfather of the author. Molaison's surgery went badly, not curing his epilepsy and leaving him profoundly amnesic, unable to form new long-term memories. But his loss became a boon to science, and he became arguably the most studied human in the history of neuro-science, known in numerous scholarly papers as patient H.M. Dittrich interweaves the story of -Molaison's life as an experimental subject with tales of the exploits and hubris of his larger-than-life grandfather and his own family's experience with mental illness. Well read by George Newbern. There is a great deal of fascinating material here and some very good writing, but the book tries to do too much, digressing at length into such sidelights as Egyptian neuroanatomy and Nazi human experimentation. VERDICT Recommended for those interested in the history of neurology. ["Dittrich has written a fascinating and at times deeply disturbing account of the history of psychosurgery that's accessible to the layperson": LJ 7/16 review of the Random hc.]-Forrest Link, Coll. of New Jersey Lib., Ewing © Copyright 2016. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Table of Contents
| Prologue | p. xi |
| Part I Origins | |
| 1 The Fall | p. 3 |
| 2 Crumpled Lead and Rippled Copper | p. 12 |
| 3 Dream Jobs | p. 20 |
| 4 The Bridge | p. 27 |
| 5 Arline | p. 38 |
| Part II Madness | |
| 6 Pomander Walk | p. 51 |
| 7 Water, Fire, Electricity | p. 63 |
| 8 Melius Anceps Remedium Quam Nullum | p. 75 |
| 9 The Broken | p. 89 |
| 10 Room 2200 | p. 98 |
| 11 Sunset Hill | p. 105 |
| 12 Experiment Successful, but the Patient Died | p. 110 |
| 13 Unlimited Access | p. 122 |
| 14 Ecphory | p. 134 |
| 15 The Vacuum and the Ice Pick | p. 144 |
| Part III The Hunt | |
| 16 It Was Brought into the Sea | p. 159 |
| 17 Proust on the. Operating Table | p. 179 |
| 18 Fortunate Misfortunes | p. 190 |
| 19 Henry Gustave Molaison (1926-1953) | p. 201 |
| Part IV Discovery | |
| 20 Where Angels Fear to Tread | p. 219 |
| 21 Monkeys and Men | p. 234 |
| 22 Interpreting the Stars | p. 250 |
| 23 The Son-of-a-Bitch Center | p. 259 |
| 24 The MIT Research Project Known as the Amnesic Patient H.M. | p. 267 |
| Part V Secret Wars | |
| 25 Dewey Defeats Truman | p. 293 |
| 26 A Sweet, Tractable Man | p. 316 |
| 27 It Is Necessary to Go to Niagara to See Niagara Falls | p. 322 |
| 28 Patient H.M. (1953-2008) | p. 336 |
| 29 The Smell of Bone Dust | p. 347 |
| 30 Every Day Is Alone in Itself | p. 357 |
| 31 Postmortem | p. 379 |
| Epilogue | p. 407 |
| Acknowledgments | p. 413 |
| Index | p. 417 |