Sunday, May 8, 2016

Review of "Permanent Present Tense: The Unforgettable Life of the Amnesic Patient, H.M." by Suzanne Corkin

Henry Molaison, born in Connecticut in 1926, had loving parents and a happy childhood. The highlight of his young days was a junior high school graduation gift from his parents - a short plane ride (costing $2.50) where he actually got to handle the controls. By then, however, Henry had already begun to suffer 'fading out' episodes which eventually became frequent and severe epileptic fits.

A common treatment for epilepsy at the time involved destroying the parts of the brain thought to trigger seizures. So in 1953, when Henry was 27 years old, Dr. William Scoville performed a bilateral lobectomy, removing a considerable amount of tissue from both sides of Henry's brain. Unfortunately, this resulted in severe anterograde amnesia - Henry was unable to form any new memories; and some retrograde amnesia - Henry could not recall some things from before the operation.

Henry's condition came to the attention of doctors interested in brain/memory research and he eventually became the long-term research subject of Dr. Suzanne Corkin and her team at the Department of Brain and Cognitive Sciences at MIT - who tested Henry periodically for 46 years. Henry was always friendly and cooperative at MIT, even though he didn't remember the researchers from one visit to the next - or even one minute to the next if they left the room and returned. However, Henry came to believe he knew Dr. Corkin 'from high school' and playfully called her 'Doctress' - and the entire MIT team became very fond of the cordial man.

Several times each year Henry was picked up from his home in Connecticut and driven to MIT, where he remained for days to weeks at a time for testing. The book describes the numerous brain scans performed on Henry as well as the many tests devised to elucidate aspects of his memory including:
working memory (short term briefly remembering a phone number);
procedural memory (performing a learned hitting a baseball);
episodic memory (recalling a personal going to prom);
semantic memory (knowing Columbus discovered America);
spatial memory (familiarity with knowing the layout of a house)

Henry's abilities (or lack thereof) helped scientists learn more about the various parts of the brain and how they interact.

Corkin also talks about Henry's personal life, which was challenging. Henry couldn't go out alone or take care of himself and - over the course of his life - lived with his parents (his mom after his dad died); in the home of caring relatives; and finally in a nursing home. Henry had to be constantly reminded about personal hygiene (shower, deodorant, teeth brushing); reminded it was time to go to bed; time to eat; etc. In one experiment at MIT Henry was served dinner, after which another plate of food was presented to him. Henry didn't remember having eaten and readily consumed the additional meal. Henry DID recall some things: he didn't like liver and he preferred cake to salad. Henry also enjoyed watching television, reading magazines, and doing crossword puzzles.

Some of Henry's difficulties were familiar to me because my mother has serious memory problems due to age-related dementia. Thus, she repeats things over and over; asks the same questions again and again; can't remember having eaten; doesn't recall that her husband died; gets confused about who's on the phone; and so on.

Dr. Corkin made careful and detailed advance plans - involving many scientists and researchers - for what to do with Henry's brain after his death. Thus when Henry died - in 2008 at the age of 82 - his head was quickly embedded in ice and his body was rushed to Massachusetts General Hospital for an extended brain scan. Then, following an autopsy, Henry's brain was flown to the University of California at San Diego. There, the organ was preserved and cut into thousands of thin slices for later study by qualified scientists. The plan is to (eventually) make all research results available on the internet.

As I read the book I felt very sad about Henry's circumscribed life, probably worse than Henry himself, who couldn't remember how bad off he was. I also felt angry at Dr. Scoville, who apparently gouged out too much of Henry's brain. (Note: cutting out pieces of people's brains 'for medical reasons' strikes me as a terrible idea in any circumstances.)

On the other hand, I'm glad that Henry's misfortune had a positive side, in the form of his vast - and continuing - contribution to science.

Most of the book is quite technical, with a lot of jargon about brain anatomy, kinds of memory, how memories form, medical tests, and so on. Thus, it might not appeal to the general public. However, for people interested in the brain and memory the book is well worth reading.

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