Patient H.M. (27 page)

It's been four decades since that day in the OR, and though Spencer went on to have a long and illustrious career, eventually becoming the head of the Yale department of neurosurgery and the president of the American Association of Neurological Surgeons, he'll always remember exactly what my grandfather said to him then, back in that long-gone era when giants like Wild Bill still roamed the earth, leaving all those great stories in their wake.

“Spencer,” he said, “we've just found the son-of-a-bitch center!”

M
y mother remembers spending many nights sitting by her bedroom window holding an empty tin can to her ear. Her bedroom was on the second floor of their house, 334 North Steele Road, in a tree-shaded neighborhood of West Hartford, Connecticut. She had removed the top of the can and nailed a hole through the bottom of it, then inserted a thick string, which she tied into a fat knot so that even when she tugged on it, it wouldn't come loose. The string extended from the bottom of the can and stretched across North Steele Road to a house directly opposite hers and into another second-floor bedroom window, where one of her best friends, Suzanne, would be speaking into a tin can of her own. The two houses were identical to each other, designed by the same architect, mirror images on opposite sides of the street. Suzanne's words vibrated along the taut string, then resonated in the can and thrummed in my mother's ear.

They became neighbors in first grade and stayed neighbors through high school, and neither Suzanne nor my mother remembers exactly how old they were when they began making those tin can telephones, or when they outgrew them. They don't remember the specifics of their conversations. They might have talked about friends, movies, music. My mom's dog, Wiggles; Suzanne's dog, Skippy. The latest radio episodes of
The Shadow
and
The Lone Ranger.
Maybe, eventually, boys.

Two young girls in suburban postwar America, proto-texting deep into the night.

In the winter, on weekends, my grandfather would often take Suzanne and my mother and my uncles Peter and Barrett along on ski trips, driving to and from the mountains at his usual breakneck speeds. Suzanne's house and my mother's were identical, but their fathers were very different: Suzanne's was an unassuming engine-parts salesman; my grandfather was a dashing neurosurgeon with a rotating fleet of sports cars. From an early age, Suzanne decided she wanted to be a doctor when she grew up. She began assembling her own first-aid kits and taking them off to summer camp with her so she could tend to any skinned knees or bee stings she encountered among her camp mates.

Whatever admiration Suzanne felt for my grandfather, there is evidence it was not mutual. Once, during high school, my uncle Barrett got into a fistfight in their backyard with another boy. A crowd of children gathered, and my grandfather watched, too. Suzanne was there. She was rooting for the other boy. When Barrett lost, my grandfather grabbed Suzanne by the arm and dragged her off the property, telling her she was no longer welcome in his home. It was the only time my mother ever saw her father engaging in an act of physical aggression against another person.

In 1955, two years after Henry's operation, my mom and Suzanne both graduated from the private Oxford School in West Hartford, and the following fall both of them enrolled at Smith College. Suzanne studied premed, but her first chemistry course dissuaded her from her childhood goal of becoming a medical doctor, so she shifted to psychology. My mom studied English. Postcollege, the paths taken by the two of them diverged. After a stint as an Avon Lady, my mom discovered a passion for early childhood education and opened a series of progressively minded daycares, models of socioeconomic and racial integration. Suzanne, meanwhile, stayed in the world of higher education and became a university professor and a PhD. But they remained friends. They both eventually settled in the Boston area, where I was born. Growing up, I saw Suzanne now and then. My mom would have her over for dinner, or we'd all go out to eat. Suzanne had gotten married and divorced by then and changed her last name to Corkin. She had three kids, two boys and a girl, all roughly my age.

I knew Suzanne was my mom's oldest friend, but I didn't know much about her beyond that.

I know a lot more now.

I know, for example, that when my grandfather died and my mother was helping settle his estate, she chose to give Suzanne an unusual memento: the anonymous human skull that he'd kept in his home office.

I also know that Suzanne inherited much more than that skull from my grandfather.

Decades before my grandfather died, she'd already taken possession of his most famous patient.

After graduating from Smith, Suzanne Corkin moved to Montreal to pursue a doctorate in psychology at McGill. It was 1960, and shortly after she arrived she read a recent paper in the
Journal of Neurology, Neurosurgery & Psychiatry
and realized that the William Beecher Scoville who co-authored it was the same William Beecher Scoville she'd grown up across the street from, the dashing neurosurgeon who was the father of one of her oldest friends. The other author, of course, was Brenda Milner. A year later, Corkin had the opportunity to join Milner's laboratory at the Montreal Neurological Institute, and she took it. She began working on her PhD thesis there, an exploration of the effects of different types of brain lesions on somesthetic function, otherwise known as sense of touch. Most of Corkin's research subjects were patients of Wilder Penfield's, men and women he'd operated on to treat their epilepsy. Corkin would run them through various tasks, such as trying to identify common objects—a comb, a bottle cap, a book of matches—simply by handling them, or trying to see at which moment, when she moved two sharp points slowly together on their skin, the two points became indistinguishable from each other. Like her mentor Milner, Corkin became a meticulous investigator, keeping careful notes, always trying to determine whether some sensory deficits might have been caused by aspects of the patients' personal histories rather than their brain lesions, such as one subject whose dulled sense of touch Corkin assumed was “probably attributable to calluses on both thumbs, a result of the patient's janitorial work.”

Although memory wasn't Corkin's focus, one of the tests in her arsenal did relate to memory. It was called a tactually guided maze, and it was supposed to measure a research subject's ability to learn to navigate a labyrinth by touch alone. The maze was cut into a sheet of aluminum over a wooden box and hidden behind a curtain. Subjects would reach their hands through the curtain and use a stylus to try to get from the beginning to the end of the maze, and Corkin would ring a bell every time the stylus hit a dead end. Using a stopwatch, she would time how long it took subjects to reach the finish, then she would run them through the maze again and again, seeing if they eventually got faster and made fewer errors. Her main intention was to measure the subjects' ability to learn the route, but of course this was also a sort of memory task: If the subjects got better at solving the maze, it was because they were remembering the correct path. Most of Penfield's patients had no trouble with the task. Whatever small unilateral lesions he'd made in their brains did not at all compromise their ability to learn by touch or any other sense.

Then, in May 1962, Henry visited the Montreal Neurological Institute. Milner had organized the visit, and it was the first time she had an opportunity to observe Henry outside of my grandfather's office in Hartford. Henry rode the night train up with his mother, Lizzie. They stayed for a week, spending their nights at a rooming house near the Neuro. Lizzie, who'd spent most of her life in sleepy Connecticut and rural Louisiana, seemed intimidated by the bustle and tumult of Montreal. Milner encouraged her to get out and explore the city, but Lizzie chose not to and instead spent most of her days sitting on a bench in a hallway at the Neuro, waiting for the scientists to finish doing whatever they were doing to her son. Milner worried that Lizzie was going to get bored, but she had no such worries about Henry. For one thing, it seemed unlikely that when every minute was entirely new to you, detached and separate from the endless chain of minutes that preceded it, boredom was even possible. For another thing, they kept him busy.

During that week, Henry submitted to a huge number of tests. Many were repeats of ones he had taken before, though he didn't recall having done so. Milner and her graduate students retested his IQ, his immediate recall of numbers, and his ability to trace a star in a mirror, among other things. Milner wanted to see if the passage of time had caused any changes to Henry's condition. It had not, in any significant way. Milner also allowed her graduate students their own time with Henry, to present him any new tasks that they thought might be illuminating. Henry was not quite famous yet, but his unique importance as a research subject was becoming clear. Even at the Neuro, where working with lesion patients was routine, Henry stood out, his lesions bilateral, his amnesia deeper, his scientific utility unquestionable.

Corkin met Henry for the first time that week. She shook hands with him and his mother in a hallway at the Neuro, then led Henry back to a testing room. They made small talk, chatting about Hartford, their mutual hometown. Corkin's mom had once attended St. Peter's school, just like Henry, and Corkin was born at Hartford Hospital in 1937, just sixteen years before Patient H.M. was born, in a manner of speaking, in my grandfather's operating room. Henry was eleven years older than Corkin, and the two came from vastly different backgrounds—Henry was firmly working-class, while Corkin would describe her own upbringing as privileged—but there were common threads of experience. After talking for a little while, Corkin sat Henry down at a table and pulled up a chair across from him. On the table was her tactually guided maze, although a screen was placed in front of it so Henry could not see it. Corkin explained the procedure. She gave Henry the stylus, then took hold of his hand and brought it to the start of the maze. She gently guided it through to the finish, to give him a basic orientation, then brought his hand back to the start, released it, and picked up her stopwatch and her bell. Henry began.

The first time he navigated the maze he made almost exactly eighty errors, each eliciting one ring of Corkin's bell. The second and third time he made slightly fewer errors, and on his tenth attempt he made additional improvements, committing only seventy-two errors. The eleventh time, however, his score regressed: He made the wrong move more than eighty times. Corkin tested him on the maze over a period of two days, observing him over dozens and dozens of attempts, and by the end he had shown no net improvement in terms of the number of errors he was making. Henry's amnesia evidently completely prevented him from memorizing the correct path through the maze. This was not surprising. When reviewing the data later, however, Corkin noticed something: Although Henry's overall rate of errors never improved, the time it took him to complete the maze did. On his first attempt, it took him about ninety seconds. On his final attempt, it took him less than forty. So although he clearly hadn't learned the maze itself, he had learned something. Specifically he became more adept at the physical procedure of navigating the maze, of guiding a stylus around a hidden track. Like most people, he moved the stylus in a slow, cumbersome way at first, but by the end he was moving it quickly and confidently. This was in some ways similar to Henry's results on Milner's mirror tracing test: It was another proof that his procedural memory, his memory of
how
to do things, was intact. The exciting difference, however, was that Corkin's tactually guided maze actually demonstrated both Henry's intact procedural memory and his demolished episodic memory
simultaneously.
For the first time, in one elegant experiment, Henry's strengths and Henry's weaknesses were both laid bare.

For a young graduate student like Corkin, it was a thrilling moment. It was also a pivotal one: Although she didn't know it at the time, and Henry never would, those first sessions were the start of the most intensive relationship between a research subject and a researcher in the history of science. Corkin delivered her PhD thesis—“Somesthetic Function After Focal Cerebral Damage in Man”—in July 1964, and although Henry made only a brief cameo in that thesis, he was just beginning a starring role in Corkin's career.

After graduating from McGill, Corkin moved from Montreal back to New England, accepting a position in the psychology department of MIT. The department was brand-new: A German immigrant named Hans-Lukas Teuber had founded it that same year, and Corkin was one of the first people he recruited. Teuber came to MIT by way of Harvard and New York University and had built his reputation on the careful study of lesion patients, though in his case most of the lesions he was studying were the products of war, not surgery. Most of his research subjects up to that time had been veterans, men who'd sustained penetrating head wounds of one sort or another, and Teuber had proved brilliant at teasing out the various ways their damaged brains affected them and extrapolating what that said about how normal brains worked. As he put it, he considered brain injuries “experiments of nature” and was a passionate advocate for the value of “studying the disturbances of brain function as a clue to normal modes of central nervous system functioning.” He aimed to import and instill this passion for the lesion method to his new department at MIT.

Corkin was a natural fit. Like her new boss, she, too, had amassed a great deal of useful experience working with lesion patients. Unlike Teuber's patients, most of the research subjects Corkin had worked with were not “accidents of nature” but instead the willful products of surgery, and one of them, Patient H.M., was already clearly among the most important lesion patients in history. There was a word that scientists had begun using to describe him. They called him
pure.
The purity in question didn't have anything to do with morals or hygiene. It was entirely anatomical. My grandfather's resection had produced a living, breathing test subject whose lesioned brain provided an opportunity to probe the neurological underpinnings of memory in unprecedented ways. The unlikelihood that a patient like Henry could ever have come to be without an act of surgery was important. As Corkin herself explained years later, it would be hard to conceive of, for example, the soldiers Teuber was accustomed to studying, men who'd been shot in the head, winding up with brains similar to Henry's: “To get a pure one would be rare. Because think about what it would take to blow out both hippocampi. You'd be dead. I think it would be most compatible with not being alive.”