Patient H.M. (5 page)

In retrospect, that sounds like an incredibly boring story idea, and later the editor told me she'd given the same assignment to dozens of other people, that it was a sort of hazing ritual. But I did my best with it. I roamed the city, notebook in hand, soaking up as much information as I could on a topic I'd previously known absolutely nothing about. I ended up filling the feature with mini-profiles—a man whose job it was to clean the statues, another who slept on the street near a monument to a famous Egyptian poet, a Spanish diplomat who oversaw the installation of the bust of José Martí near his embassy—and, to my surprise, the magazine accepted the story. Not only that, they were short-staffed, so they offered me a full-time job as a writer. My contract with the oil company was almost over, and I'd been planning to return to the States. I'd been thinking of going back to the moving company, working myself up from grunt to driver. The offer from
Egypt Today
had made those plans moot.

I decided to stay in Egypt, to take the job. For the first time in my life, I felt confident about my future, and that confidence, that sense of heading in the right direction, cried out for some sort of dramatic commemoration. So there I was, up on that pyramid, under that laser-beamed sky, riding that unfamiliar surge of optimism. Eventually the lasers blinked off, and the darkness descended. The tourists left their seats, and I stood and looked out over the smog-choked lights of Cairo. A light wind carried a fine grit of desert sand and the faint sound of car horns. The pockmarked Sphinx, 455 feet below, seemed as small as a kitten, and the stars above were nowhere to be seen. The Great Pyramid had been there for 4,600 years, and on that night, for a few hours, it was mine alone under my feet.

My grandfather sat shivering on the top of the George Washington Bridge. Later he would speak about the climb many times to many people. He would speak about the cold, the height, the fear, and the long night spent waiting for dawn, hiding in a packing crate. But he never, that I'm aware of, spoke about
why
he'd decided to climb in the first place.

I think I know.

He was twenty-four years old and in the process of burying his old self, the one who'd worried about always being a failure. He was halfway through medical school and discovering gifts he'd never known he had. He was learning how to make sick people better, and he was learning that this was something he could not only do but do well. He was newly confident that he was on the right path, and this feeling, this revelation, cried out for commemoration.

Of course this leap I'm making might be bullshit, but I'll defend it. There is only one way we tell stories about other people, and it's the only way we've ever told stories about other people. We find the connections between us and them, and then we use those connections as a bridge. Sometimes the connections are solid, buttressed by primary sources and interviews and every other sort of documentation you can imagine. Sometimes they're tenuous. Sometimes they're as ephemeral as two young men, divided by two generations, climbing two monuments for what the younger man believes must have been the same reasons.

My grandfather waited on top of the bridge until dawn. Maybe he slept at some point. I doubt it. I imagine him sitting there watching the lights of the city below until they were eclipsed by the light of the brightening sky. Eventually he stood and walked back to the cable and stepped out onto it. Like the man who'd jumped months before, my grandfather couldn't see the thousands of tiny filaments that united to form this one massive rope of steel beneath his feet. He didn't need to see them. He just needed them to sustain and hold him while his body coursed with adrenaline and endorphins and the sun began to warm him. Inside his skull, new neuronal connections were made, fresh impressions conveyed across yearning axons destined to imprint themselves as a memory trace that would reside there, inside him, until his last day.

One more thing: The length of all those thin strands that made up the thick cables of the George Washington Bridge—108,000 miles—not only could circle Earth four times or stretch halfway to the moon but also happened to match, almost exactly, the combined length of all the axons in the average adult human brain. Of course, they are very different, axons and steel. In the bridge, the wires came together in lockstep formation, pooling their strength in accordance with some civil engineer's formulas. In the brain, as my grandfather would have already learned during his first two years of medical school, axons came together and fell apart in infinite patterns that changed from microsecond to microsecond, conveying and creating everything we know and feel, believe and remember. He would have learned that there was no formula to describe what axons did, that they were the wiring of the brain, and that this wiring was embedded within small circuits, and those small circuits were embedded within larger ones, and the brain as a whole was made up of entire constellations of interlocking circuits. He would have studied these things and learned that a working human brain was so dauntingly complex that most of what we knew about it came from studying brains that
didn't
work, brains whose infinite circuitry had been disrupted and whose basic functions had been stifled or altered in a variety of interesting ways.

My grandfather held the guide ropes at either side of him and put one foot in front of the other. He must have felt proud. The bridge, even in its inchoate state, had already been extolled by
The New York Times
as a modern wonder of the world—“a symbol of man's mastery over matter, not less convincing than Cheops' pyramid itself”—and he had just conquered it. I imagine him, as he began his descent, freshly emboldened, ignoring the dark waters hundreds of feet below, ready to seize the opportunities that the world would soon tilt within his grasp.

T
wo twenty-six, twenty-six.

February 26, 1926.

Henry's birthday.

There it was, right on his birth certificate. The certificate sat on a black velvet pedestal, inside a sealed rectangular box made of plexiglass. There were about a dozen other items on display, too: pictures, postcards, a pair of thick-lensed, thick-framed glasses, a Social Security card, a child's drawing, a tiny silver crucifix. A sign on the display said,
PERSONAL BELONGINGS OF H.M.
and gave thanks to the scientist who had lent the items for use in this exhibit. The exhibit was in the lobby of a building on the edge of the campus of MIT, one of the universities where scientists had spent decades studying Henry.

The largest photo in the display case was black-and-white, about eight and a half by eleven inches, and mounted in a chipped gold-painted wooden frame. It didn't have any sort of identifying label, but it was clearly a class photo. The kids were maybe in second or third grade. Thirty-seven of them, almost evenly divided between boys and girls. The girls all wore dresses, the boys shirts and ties.

I leaned in close and tried to spot him.

Between second and eighth grade, while the Molaison family lived in their light-housekeeping rooms in downtown Hartford, Henry attended St. Peter's, a Catholic school near Colt Park, where that bicyclist sent him crashing to the ground. The scientists who studied Henry often asked him about his time at St. Peter's, and he told them what he could.

“It was set off from Main Street,” he said one afternoon in 1970, while sitting and smoking in an MIT laboratory, just a few blocks away from where that sampling of his personal relics would sit under plexiglass decades later. “Green grass in front of it. It was a brick building. Redbrick and white trim. White around the sill of the window. A basement and two stories…Had a window facing Main Street.”

He remembered that there was so much noise from the traffic going by on Main Street that the nuns would often have to close those windows, and that at certain times of year this made things hot and stifling. They'd keep the classroom doors open so the air would circulate.

“There's one door who was forwards,” Henry said, “and there was another door down in the back of the room, and both were open. And a draft could go through. Or a breeze.”

He remembered that some of the younger students were scared of the nuns because of the imposing habits they wore.

“The black and the white,” he said.

“Were
you
scared?” a scientist asked.

“No.”

He told them that he'd been born a lefty but one of the nuns made him learn to write with his right hand.

“They changed me over,” he said. “And my writing's never been good. But plain in a way…The sister…she was very…uh, wanted everyone to write one way.”

“Did you complain about that?” the scientist asked.

He hadn't.

“Do you remember any of the kids? Any of the other children in the class?”

“Well,” he said. “I think of one right off. I graduated with her. Her father was a cop at the time and went to become chief of police. And her name was Hallissey. Last name. First name was Arline.”

A few minutes later, the scientist asked him the question again.

Did he remember any of the other children at the school?

“I think of one right off,” he replied. “A girl. Her father is, uh, was, on the police force then….Hallissey's the name.”

“She was in the same class as you all the way through grade school?”

“Yes. Yes.”

“And what was her first name?”

“Arline,” he said.

Every time they asked him to recall another student at St. Peter's, he brought up Arline first. They had both attended St. Peter's from second through eighth grade, he said, though they hadn't always been in the same classroom. There were two classrooms for each grade, and school administrators would sometimes mix the kids as they rose through the grades. “Take some and just shift them around,” Henry explained, “to make sure they wouldn't stay all together all the way through school.” Still speaking about Arline, Henry recalled how he felt at the end of each school year, “hoping a certain one would stay with you…that they would be shifted, too.”

Henry Molaison, it seemed, once had a crush on Arline Hallissey.

The walls of the classroom in the old photo were two-toned, darker on the bottom, lighter on top. There was a slate up high on the rear wall, and someone—a nun?—had written the ultimate imperative sentence across it in chalk:
Keep My Commandments.

I studied the faces of the kids. The image had a shallow depth of field, and the faces of the students near the front of the room were in sharper focus than those in the back. In the upper left of the photo, his back against the wall, there was a boy, slightly blurred, with ramrod posture and thick-framed glasses. I thought that was probably Henry.

I looked at the girls and wondered which was Arline.

“Hello?”

“Hello. Is this Mrs. Pierce?”

“Yes.”

“Hi, Mrs. Pierce. I'm calling because I'm working on a book about a man I believe was a former classmate of yours. Did you attend, back in the late 1930s, early 1940s, St. Peter's school?”

“Right, right.”

“You did?”

“Yeah, I graduated from there.”

She had married twice since then, had twice changed her name. And the people who transcribed Henry's laboratory interviews had usually misspelled her first and maiden names. Still, I was pretty sure.

“Your father was the police chief for a while, wasn't he?”

“Right,” she said. “In Hartford.”

“Okay, then I think you must be the Arline Pierce I'm looking for! The man I'm writing about, I don't know if you remember him or not. He passed away. But in interviews he recalled you as a childhood friend of his.”

“I bet it was Bill Farrell!”

“It wasn't Bill Farrell.”

“Oh, okay.”

“It was a boy named Henry Molaison.”

There was a long pause.

“I do not…see, that name…I do not remember.”

Arline told me about the boys from St. Peter's that she
did
remember. Bill Farrell and William Brady. They both went on to become Catholic priests. One became a monsignor. “So they really made something of themselves. I remember the two priests because they were little devils. And I said, my God, how can you become priests?! You oughta be ashamed of yourselves. That's the only reason I remember them so vividly.”

I told her more about Henry. I told her he'd worn glasses, had blond hair, and lived on Main Street, just a couple of blocks from the school.

“Now, wouldn't you think I'd remember?” she said. “That name, that boy…but I can't put my finger on it, you know? When you get to be eighty-seven, you forget.”

“Henry Molaison,” I repeated, first using the usual pronunciation—
Mo-luh-son
—and then trying an alternate one: “Or Henry
Mo-lie-ah-son
?”

“Honey,” she said, after another long pause, “I don't remember that name. I truly don't.”

One day in the summer of 1980, in a testing room at MIT, a scientist asked Henry to remove his shirt. Henry was fifty-four years old and getting a little flabby around the midsection. In the previous eight years, the scientist noted, he had begun to overeat, and his weight increased from 178.13 to 194.66 pounds. In fact, on a different visit to the lab, the scientist attempted to quantify Henry's increasing appetite and found that he was capable of eating two multicourse complete dinners, one after another, without reporting a feeling of fullness, though he would abstain from the salad on the second round. She thought his amnesia had something to do with his gluttony—it's easier to eat a second meal, after all, when you don't remember the first—but she wasn't sure. Now, during this visit, the scientist was intent on measuring something else: Henry's capacity to endure pain.

She applied six circles of india ink to his chest, each two centimeters in diameter. Then she picked up her dolorimeter. Although the device's name implies that it measures pain (
dolor
is Latin for
pain
), this is not exactly correct. What it does is cause pain. Its utility lies in the fact that the pain it causes is discrete, standardized, and adjustable. The dolorimeter looks like a gun, and there's a one-hundred-watt bulb inside it. The radiant heat energy from the bulb is directed and focused down the barrel through a series of lenses. Once the dolorimeter is activated, the heat at the tip of the barrel can be adjusted upward from zero in increments to a maximum of 370 millicalories, enough to cause second-degree burns.

She sat Henry in a chair and then applied the dolorimeter to his chest in the middle of one of the circles. During each application, she would hold the device to Henry's skin for three seconds and ask him to rate the intensity of the pain he was experiencing. During her tests with control subjects, she found that they tended to rate zero millicalories as “nothing,” 90 millicalories as “warm,” 180 millicalories as “very hot,” 280 millicalories as “very faint pain,” and 320 millicalories as “very painful.” At the 370 millicalories setting, all of the control subjects found the pain to be so intense that they couldn't endure the three seconds of required contact and instead flinched away from the dolorimeter within fractions of a second.

Henry was different. He reported no pain at all through the dolorimeter's entire initial spectrum. Then the scientist cranked it all the way up to 370 millicalories and pushed the tip against his chest. Henry sat calmly as she held it there for the full three seconds, even as his skin began to burn and turn red.

“Unlike the control subjects,” the scientist wrote later, “H.M. did not label any stimuli painful, no matter how intense it got.”

The scientist speculated that Henry's high pain tolerance had something to do with the lesions to his brain, though again she couldn't say for sure. Other amnesic patients she had tested in similar fashion experienced normal pain sensitivity. What made Henry different?

Henry put his shirt back on and returned to the room he slept in during these visits to the laboratory. There, he likely pulled out a crossword book, picked up a pencil, and began quietly working one of his puzzles.

If Henry Molaison had a boyhood crush on Arline Hallissey, it was an unrequited one.

Later, after the operation, Henry never had a crush on anyone again.

The holes my grandfather dug in Henry's brain caused many deficits, some brutal and stark, some more subtle. Among the things he lost, according to the scientists who studied him, was a capacity for desire. As far as they could tell, in the six decades between his operation and his death he never had a girlfriend, or a boyfriend, never had sex, never even masturbated. The returning strangers who flitted in and out of his life, the movie stars who flickered on his television, he received them all with perfect neutrality, and they left behind neither traces of memory nor pangs of lust.

“The operation,” one of the scientists who studied him concluded, “rendered him asexual.”

There is no equivalent device to the dolorimeter to administer emotional as opposed to physical pain, but if there were, many of the people who studied Henry believed, he probably would have displayed a similar numbness. He was known for his outward placidity, for his equanimity, for the flatness of his demeanor. He tolerated whatever the scientists wanted to do to him without complaint. Patient H.M. was, above all else, patient. On the surface, at least, he rarely seemed troubled, even when confronted with troubling facts. After his parents had both died, for example, the scientists would often ask him about them to determine whether even such massive losses had made an imprint in his mind. In a characteristic exchange in 1986 two weeks before Henry's sixtieth birthday, five years after his mother died, and almost two decades after the death of his father, Henry had the following exchange with an MIT researcher: