The Best American Science and Nature Writing 2011 (11 page)

Patient I. S.: "54-year-old woman ... auditory hallucinations and marked emotional lability..."

Patient A. L.: "31-year-old schizophrenic man ... auditory and visual hallucinations..."

Patient M. B.: "55-year-old manic depressive woman ... anxious, irritable, argumentative, and restless..."

And on and on, quick sketches of profound damage. Many of these cases interest Milner—particularly Patient D. C., a brilliant and psychotic medical doctor who attempted to kill his wife—but she returns from her asylum odyssey convinced of Henry's singular importance. Though some of the asylum patients clearly suffer from a similar amnesia to Henry's, Henry uniquely combines a near-complete resection of both hemispheres of the hippocampus with a mind not otherwise muddied by mental illness. The only other patient who received an operation identical to Henry's—a "radical bilateral medial temporal lobe excision (with the posterior limit of removal 8 cm from the temporal tips)"—is so deeply disturbed that nobody even noticed her inability to create new memories until nearly a year after her surgery.

Henry is the one.

The testing begins.

 

In 1848 an explosion drives a steel tamping bar through the skull of a twenty-five-year-old railroad foreman named Phineas Gage, obliterating a portion of his frontal lobes. He recovers and seems to possess all his earlier faculties, with one exception: the formerly mild-mannered Gage is now something of a hellion, an impulsive shit-starter. Ipso facto, the frontal lobes must play some function in regulating and restraining our more animalistic instincts.

In 1861 a French neurosurgeon named Pierre-Paul Broca announces that he has found the root of speech articulation in the brain. He bases his discovery on a patient of his, a man with damage to the left hemisphere of his inferior frontal lobe. The man comes to be known as Monsieur Tan, because, though he can understand what people say, "tan" is the only syllable he is capable of pronouncing.

Thirteen years later, Carl Wernicke, a German neurologist, describes a patient with damage to his posterior left temporal lobe, a man who speaks fluently but completely nonsensically, unable to form a logical sentence or understand the sentences of others. If Broca's area, as the damaged part of Monsieur Tan's brain came to be known, is responsible for speech articulation, then Wernicke's area must be responsible for language comprehension.

And so it goes. The broken illuminate the unbroken.

There is a word neuroscientists use to describe Henry. They call him pure. The purity in question doesn't have anything to do with morals or hygiene. It is entirely anatomical. My grandfather's resection produced a living, breathing test subject, Patient H. M., who will allow scientists to study how memory works with, as Brenda Milner will write, "the exactness of a planned experiment." And it is unlikely that a patient like Henry could arise without the willful act of a surgical procedure. Another scientist who later studies Henry discounts the possibility, for example, that a soldier might wind up with a brain similar to Henry's by being shot in the head: "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."

Henry is the purest, and his purity makes him valuable.

Shortly after Milner's first visit with Henry, she and my grandfather begin coauthoring a paper, "Loss of Recent Memory After Bilateral Hippocampal Lesions," which appears in 1957 in the
Journal of Neurology, Neurosurgery and Psychiatry.
The paper, which formally introduces the scientific world to Patient H. M., reaches a deceptively straightforward conclusion: since my grandfather removed Henry's hippocampus and Henry no longer seems capable of creating new memories, the hippocampus must play an essential role in creating new memories.

That paper—which for the first time convincingly localizes memory function to a specific part of the brain—becomes the founding text of modern memory science.

But Milner continues riding the night train down to Hartford, spending days at a time with Henry. Her initial focus is on probing the depths of his memory dysfunction, the way experiences seem to slip
away
from him, leaving no trace. Then she begins investigating whether there are any experiences at all that he can remember.

One afternoon she sits Henry down at a desk and puts a piece of paper in front of him. The paper has a large drawing of a five-pointed star on it. There is a mirror angled at the star and a curtain over the paper so that Henry can no longer see the star directly but can see only its reflection in the mirror. She asks him to trace the star. It's a hard task for anyone, with any sort of brain, though after a while, with practice, people with normal brains tend to improve their results, mastering the necessary counterintuitive muscle movements. The first time Henry tries it, he performs poorly. But the funny thing is, the next time he tries, he does it a little better. And the next time better still. With each new attempt, he never remembers ever having attempted it before, but soon he's completing the task as well as anyone. Even Henry recognizes the strangeness of this.

"I thought this would be difficult," he says to Milner after tracing the star almost perfectly, "but I seem to have done this well."

In 1962 Milner publishes her account of the star-tracing experiment. That article arrives at another simple but revolutionary conclusion: since Henry is incapable of consciously remembering the events he's living through but seems to be able to unconsciously remember how to perform certain physical tasks, the human mind must contain at least two separate and independent memory systems. The world of memory science is upended again.

Less than a decade after his surgery, the study of Henry's incomplete brain has already spawned the century's two pivotal insights into how memory works. Milner has revealed him to be a sort of human Rosetta stone, an incarnate key to ancient mysteries.

Henry himself, of course, is oblivious to his own burgeoning importance. After the operation, he continues to live with his parents. The operation did succeed in reducing the frequency and severity of his seizures, and Henry is perfectly capable of helping out with tasks around the house. He can mow the lawn just fine, since the cut grass itself shows him what he has already cut and what he has not. His father, an electrician, dies in 1967, when Henry is forty-one years old. Henry goes back to work, packing lighters at a rehabilitation center designed to provide constructive occupations for mentally retarded people. A few years after that, he and his mother, whose health is failing, move into the home of an aunt. In 1977 Henry's mother moves into a nursing home. Henry lives alone with his aunt until 1980. When she becomes too ill to care for him, he moves into the Bickford Health Care Center. A conservator is appointed, a cousin of Henry's, and that conservator, like Henry's guardians before him, signs waivers allowing the scientists to continue their work.

Milner spends nearly two decades studying Henry. Then she moves on, pursues other research interests, lets other scientists pick up with Henry where she left off.

Researcher: Are you happy?

Henry: Yes. What I, well, the way I figure it is, what they find out about me helps them to help other people. And that's more important. That's what I thought about being, too. A doctor.

R: Really?

H: A brain surgeon.

R: Tell me about that.

H: And as soon as I started to wear glasses, in a way, I said no to myself.

R: Why?

H: Because [during] brain surgery you have bright lights, and I thought there would be an extra glare from the rim of your glasses that would go into your eye. And right at the moment you want to make the great reseverance, the most important severance, you just might move a little too far...

Jacopo Annese usually drives a Porsche, but today, summer 2006, he's a passenger in a sedan watching the desiccated red-brick husks of old paper mills glide by his window. Main Street, Windsor Locks, Connecticut, just a few blocks from the Bickford Health Care Center, where he's going to meet Henry for the first time. He's a little surprised, to be honest, that Suzanne Corkin, who's driving, didn't make him wear a bag over his head. Corkin, a former graduate student of Brenda Milner's at McGill, who runs the Behavioral Neuroscience Laboratory at MIT, took over as the lead investigator on all things Henry-related in the late 1970s. She is known to be fiercely protective of her prized test subject, vetting researchers exhaustively, demanding the signing of nondisclosure contracts, disallowing tape recorders, that sort of thing. She's built a good portion of her career on her special access to Henry, and she won't let just anybody in.

But when Annese requested that she set up this meeting, when he told her that he'd really like to see Henry at least once while Henry was still alive, she consented, arranged it, even chauffeured him.

Corkin first met Henry at Brenda Milner's lab in Montreal in 1962, and over the years, as the mining of his mind has continued, she's witnessed firsthand how Henry continues to give up riches, broadening our understanding of how memory works. But she's also keenly aware of Henry's enduring mysteries, has documented things about him that nobody can quite explain, not yet.

For example, Henry's inability to recall postoperative episodes, an amnesia that was once thought to be complete, has revealed itself over the years to have some puzzling exceptions. Certain things have managed, somehow, to make their way through, to stick and become memories. Henry knows a president was assassinated in Dallas, though Kennedy's motorcade didn't leave Love Field until more than a decade after Henry left my grandfather's operating room. Henry can hear the incomplete name of an icon—"Bob Dy..."—and complete it; even though in 1953 Robert Zimmerman was just a twelve-year-old chafing against the dead-end monotony of small-town Minnesota. Henry can tell you that Archie Bunker's son-in-law is named Meathead.

How is this possible?

And Corkin has discovered a number of other curious, anomalous, presently inexplicable things about Henry. For instance, if she holds a dolorimeter, a handheld, gun-shaped device housing a hundred-watt bulb, to the underside of Henry's forearm, he is able to tolerate the resulting pain for longer periods of time than most people. Is he naturally, congenitally pain-resistant? Or did my grandfather's removal of his amygdala, an organ that sits just in front of the hippocampus and is suspected to mediate both emotion and pain, account for his toughness?

And why, as Corkin has also discovered, is Henry able to recognize the intensity of smells but not their provenance, unable to discriminate the fragrance of a rose from the stench of dog shit? Is the hippocampus responsible for smell identification as well? Or had my grandfather's "suction catheter" inadvertently damaged Henry's nearby olfactory bulb as well?

You can spend a half century testing somebody, examining, poking, prodding, feeding—Henry will happily eat at least two full dinners in a row if you give him a minute between removing the first tray and replacing it with the second—and you can come up with all sorts of theories to explain your findings. You can even throw a person in an MRI machine, study the flickering images on your computer screen. But the brain is the ultimate black box. Eventually, to grasp the first cut, you'll have to make another.

The car pulls into the parking lot of the nursing home, noses into an empty space. Annese and Corkin get out and walk inside together. Henry's waiting. The three have lunch in the cafeteria.

He's an old man now, overweight, wheelchair-bound, largely incommunicative. Lately, Henry's creeping decrepitude has itself suggested some new experiments. During another meeting, Corkin quizzed Henry on how old he thought he was. He guessed that he was perhaps in his thirties. Then she handed him a mirror.

"What do you think about how you look?" she asked while he stared at himself.

"I'm not a boy," he said eventually.

Still, despite Henry's current condition, his lack of engagement, Annese is glad to get a chance to meet him, to spend at least a little time around him. Ever since graduate school, he's always found the anonymous cadavers the hardest. It makes it much easier, for some reason, if you know something about the person as a person before you deal with the person as a corpse.

On the way out, Annese notices a snapshot of Henry tacked to one of the bulletin boards near the entrance. Nobody's looking, and he has to resist the temptation to take it, to slip it into his pocket, to keep it as a sort of totem, something he could ponder in his off-hours, something he could use to help him imagine his way further into Henry's mind before the day he has to start digging into his brain.

 

Sometime around 1969, in the middle of taking some tests, Henry suddenly stopped and looked up at his examiner.

"Right now," he said, "I'm wondering, have I done or said something amiss? You see, at this moment, everything looks clear to me, but what happened just before? That's what worries me. It's like waking from a dream."

He might have said the same thing, felt the same way, in 1979, 1989, 1999. Every day, every waking hour. The world around him evolving, changing, growing, while the world within him cycles endlessly, fruitlessly. Memory is the traction of our lives. Without it, you can't move. You're nowhere at all, really. Like when you're just waking from a dream.

Some researchers once decided to find out what would happen if you actually did wake Henry from a dream. He spent several nights in a sleep laboratory, hooked up to sensors. Whenever he entered REM sleep, a researcher would shake him till his eyes opened and then ask him what he'd been dreaming about. He usually just talked about the same sorts of things he liked to talk about when he was awake—childhood memories of a road trip to Florida with his parents, of shooting targets in his backyard, of fishing with his dad. In the end, the researchers never published their dream studies, because nobody could decide whether Henry was dreaming at all, whether he was even capable of dreaming. But some of the transcripts survived.